Targeting sleep disorder in Crohn's and other IBD patients

A new Flinders University-led study recommends people with IBD be screened for obstructive sleep apnea (OSA), a common and debilitating respiratory condition, to improve their long-term health.

OSA is linked to a variety of medical conditions including cardiovascular disease, stroke, obesity, Parkinson's, anxiety and depression and gastro-esophageal reflux disease, with Flinders and SA Health researchers developing a new screening tool to identify possible sleep apnea in IBD patients. IBD is a chronic relapsing-remitting inflammatory condition that is increasing in frequency worldwide.

"We are developing a novel screening tool for sleep apnea which could help identify and manage OSA in IBD patients who already battle with abdominal pain, along with possible daytime sleepiness, obesity, increasing age, smoking and other health and well-being problems and long-term risks," says Flinders University sleep researcher Dr. Alex Barnes, from the SA Health Southern Adelaide Local Health Network Gastroenterology Department based at the Flinders Medical Center.

"Our study of 670 IBS patients found moderate to high risk of OSA in about 22.6% of the cohort, many of whom were struggling with their pain burden, weight, smoking, depression and at least mild daytime sleepiness."

The study finding published in the Crohn's and Colitis 360 journal recommends the use of an accessible OSA screening for IBD clinics in order to refer patients to a sleep specialist.

"Identification of those with OSA will allow screening for associated cardiovascular complications and commencement of treatments such as continuous positive airway pressure (CPAP)," says co-author Dr. Réme Mountifield, also from the SAHLN Gastroenterology Department and Flinders University Sleep Health group, who collaborated with other SA Health and University of Adelaide experts in the new study.

"While the study's online questionnaire had limitations, overseas research has already confirmed OSA is more common in people with IBD, so a simple screening tool for OSA using typical IBD clinic parameters would be a useful way to start addressing this often undiagnosed problem."

Associated gastrointestinal symptoms often leads to disrupted sleep leading to poor sleep quality, with active IBD associated with elevated TNF-a (tumor necrosis factor-alpha) levels which may influence the course or severity of OSA.

Inadequate and disrupted sleep has a negative effect on the health and well-being of four out of 10 Australians who are estimated to have sleep problems, with a majority of about 1.5 million adult Australians living with undiagnosed serious sleep disorders.