The sleep quality and its association with disease activity in patients with inflammatory bowel disease: a meta-analysis.

BACKGROUND

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is linked to poor sleep quality, though evidence remains inconsistent. This meta-analysis aimed to evaluate sleep quality in IBD patients and its association with disease activity.

METHODS

We systematically searched databases up to February 2025 for studies reporting sleep quality in IBD. Outcomes included pooled prevalence of poor sleep, odds ratios (ORs), and standardized mean differences (SMDs) comparing IBD patients to controls, UC vs CD, and active vs inactive disease. Heterogeneity was assessed using Cochran's Q and I² statistics.

RESULTS

Fifty-five studies were included. Poor sleep prevalence was 60% in IBD, 52% in UC, 56% in CD, and 68% in active IBD. IBD patients had higher odds of poor sleep than controls (OR: 1.90, 95% CI: 1.38-2.61; SMD: 0.61, 95% CI: 0.32-0.89). No differences emerged between UC and CD (OR: 0.93; SMD: -0.04). Active IBD patients showed elevated poor sleep risk versus those in remission (OR: 2.09, 95% CI: 1.50-2.90), driven by CD (OR: 2.40, 95% CI: 1.42-4.05). SMDs for active vs inactive disease were 0.49 (IBD overall), 0.40 (UC), and 0.73 (CD).

CONCLUSION

Poor sleep is highly prevalent in IBD, particularly during active disease, with significantly higher rates than in healthy controls. Sleep quality did not differ between UC and CD. Addressing poor sleep in IBD management and exploring underlying mechanisms are crucial for improving patient outcomes.