P0081Stress, Sleep, and Inflammation in Inflammatory Bowel Disease (IBD): A Prospective Cohort Study

Background Chronic stress and poor sleep are recognized modulators of the brain–gut axis. Their specific impact on disease activity in inflammatory bowel disease (IBD) remains underexplored, particularly in North African populations. Aim To assess the relationship between perceived stress, sleep quality, and clinical and biological activity in patients with IBD. Methods This prospective observational study was conducted at Mohammed VI University Hospital between January 2024 and July 2025. A total of 135 adult patients were enrolled (Crohn’s disease = 72, ulcerative colitis = 63). The Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS) were assessed at baseline (M0), month 3 (M3), and month 6 (M6), along with clinical activity (CDAI or partial Mayo score) and biomarkers (CRP, fecal calprotectin). Statistical analyses included Spearman correlations and multivariate logistic regressions adjusted for age, sex, BMI, smoking, and biologic therapy. Results Mean age was 38.5 ± 11.4 years; 52 % were female and mean BMI was 24.1 ± 3.8 kg/m². During follow-up, 42 patients (31 %) experienced a clinical relapse. Patients with relapse had significantly higher PSS (26.1 ± 5.9 vs 20.4 ± 6.0; p < 0.001), higher PSQI (9.8 ± 2.9 vs 7.9 ± 3.1; p = 0.002), and elevated CRP (18.4 ± 12.1 vs 10.5 ± 8.7 mg/L; p = 0.001). Fecal calprotectin was also increased (501 ± 289 vs 365 ± 241 µg/g; p = 0.008). In multivariate analysis, PSS ≥ 24 (OR = 2.6, 95 % CI 1.3–5.4, p = 0.007) and PSQI ≥ 9 (OR = 2.1, 95 % CI 1.1–4.0, p = 0.018) were independent predictors of relapse at 6 months. Conclusion High perceived stress and poor sleep quality are independently associated with increased disease activity in IBD. Incorporating psychosocial assessment and sleep hygiene into patient follow-up may improve overall disease management and reduce relapse frequency. Conflict of interest: Dr. Aouroud, Hala: No conflict of interest Aouroud, Meryem: No conflict of interest Nacir, Oussama: No conflict of interest Lairani, Fatima Ezzahra: No conflict of interest Ait Errami, Adil: No conflict of interest Oubaha, Sofia: No conflict of interest Samlani, Zouhour: No conflict of interest Krati, Khadija: No conflict of interest