P205 Influencing factors of Sleep quality in patients with Crohn's Disease

Sabbah, M.(1);Jlassi, H.(1);Bellil, N.(1);Trad, D.(1);Ouakaa, A.(1);Bibani, N.(1);Gargouri, D.(1);

(1)Faculty of medicine of Tunis, Department of gastroenterology. Habib Thameur Hospital, Tunis, Tunisia


Sleep is considered vital for the health and quality of life of individuals. Recently, studies have suggested that sleep disturbances are common in people with Crohn's disease (CD) and in the majority of cases are related to disease activity.The aim of our study was to determine the prevalence of insomnia in patients with CD and to identify the influencing factors.


A prospective cross-sectional study including patients with CD followed in the department between July and August 2020 was carried out. Epidemiological and clinical data have been collected. Self-report questionnaires were given to patients. Insomnia was assessed using the Insomnia Severity Index (ISI) which provides a valid index of the overall severity of insomnia. A score between 0 and 7 indicates the absence of insomnia; between 8 and 14 a mild infra-clinical insomnia; between 15 and 21 moderate clinical insomnia, and between 22 and 28 severe insomnia. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) questionnaire which is a scale of 14 items rated from 0 to 3. Seven questions are related to anxiety and seven to depression. Fatigue was screened for using the Fatigue Severity Scale (FSS) which has 9 questions rated from one to seven. Significant fatigue was defined by a score greater than or equal to 5.5. Statistical analysis was performed by SPSS 21 software (p significant if less than 0.05).


Thirty two patients with a mean age of 38.28 years [18-60 years] and a sex ratio equal to 1 were enrolled. Mean duration of the disease was 10.56 years [1-40 years]. At the time of inclusion, the average Harvey Bradshaw (HAB) score was 5.14 [1-14].

Mean insomnia score was 12.62 [0-26]. The insomnia severity index showed mild insomnia in 4 patients (12.5%), moderate insomnia in 7 patients (22%) and severe insomnia in 8 patients (25%).

The HADS score revealed obvious depression in 19% of patients, doubtful depression in 25% of patients. 56% of patients had no symptoms of depression. Likewise, anxiety was objectified in 22% of patients and doubtful anxiety in 37% of patients. 41% of patients had no symptoms of anxiety. The mean fatigue score was 3.75 ± 1.9 [range 1-9]. A fatigue score greater than or equal to 5.5 was observed in 3 cases (9%).

A significant positive correlation was found between the insomnia severity score and the depression score (r = 0.4, p = 0.035) as well as the fatigue severity score (r: 0.36, p = 0.04).


Our study shows that insomnia is very common in patients with CD. The factors associated with these sleep disturbances were depression and fatigue. Gastroenterologist and psychologist should join forces to evaluate emotional as well as sleep disturbances for a better global CD management.