P178 Sleep fragmentation measured by wearable device is an indicator of clinical disease activity in inflammatory bowel disease. (16th January 2018)

• Record Type: Journal Article
• Authors: Sofia, M A; Yvellez, O; Zmeter, N; El Jurdi, K; Ollech, J; Andersen, M J; Aharoni Golan, M; Rodriquez, D M; Rubin, D T
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S188
• Page End: S189
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.305
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Wearable activity monitors allow individuals to track physical characteristics, including sleep patterns. Sleep dysfunction in inflammatory bowel disease (IBD) is associated with inflammatory activity and risk for clinical disease relapse. Passive measurement of sleep by a wearable device can identify patterns of sleep dysfunction. We investigated whether remotely measured sleep quality by a wearable device is associated with clinical disease activity. Methods: Patients with Crohn's disease (CD) or ulcerative colitis (UC) were recruited from an ambulatory clinic at a tertiary care IBD centre. Medical history was collected from medical records. Each patient received a Fitbit Charge HR (San Francisco, CA) and a smart phone application. Data from the devices included "sleep fragmentation", awakening events per hour in bed, "restlessness", restless events per hour in bed, and "sleep efficiency", time sleeping divided by time in bed. The average of up to seven days of data was then calculated. "Clinically active" was defined as Harvey-Bradshaw Index of > 4 for CD or Simple Clinical Colitis Activity Index of 1 for UC. Each parameter was compared between disease states, then logistic regression for the outcome of clinically active disease. Multivariate analysis included age, sex, diagnosis, and comorbid sleep disorder with each sleep parameter. Results: 38 patients (26 CD, 12 UC) were followed for an average of 8.87 nights. There were no significant differences between CD and UC for age, male sex, or clinically active disease, though there was a difference in the presence of comorbid sleep disorders (Table 1). A change in average sleep fragmentation by 0.1 was not predictive of clinically active disease in the univariate model, but was predictive in the multivariate model (OR 1.78 (95% CI 1.004–3.11), p = 0.02) (Table 2). While restlessness (OR 1.14 (95% CI 0.34–3.82), p = 0.82) and sleep efficiency (OR 0.019 (95% CI 8x10–5–4.41), p = 0.14) were not predictive. Conclusions: Worse sleep fragmentation measured by a wearable activity tracking device is associated with increased odds of clinical disease activity in IBD. Changes in sleep fragmentation patterns may have utility in a remote patient monitoring system as an early indicator of clinical disease activity.