Chronotype, social jet lag, sleep debt and food timing in inflammatory bowel disease

• Published in: Sleep medicine Vol. 52; pp. 188 - 195
• Main Authors: Chakradeo, Prachi S., Keshavarzian, Ali, Singh, Shubha, Dera, Akram E., Esteban, James Philip G., Lee, Alice A., Burgess, Helen J., Fogg, Louis, Swanson, Garth R.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-12-2018
• Subjects: Chronotype; Circadian rhythms; Crohn's disease; Inflammatory bowel disease; Sleep debt; Ulcerative colitis; Inflammatory bowel disease; Circadian rhythms; Chronotype; Crohn's disease; Sleep debt; Ulcerative colitis
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2018.08.002

The preference of the sleep/wake cycle can be grouped into categories or chronotypes. Inflammatory bowel disease (IBD) has been linked to poor sleep quality which correlates with disease severity. Social jet lag (SJL) is the difference between sleep timing on work and free days and is a marker for circadian misalignment which has been linked to increased inflammation. We investigated whether chronotype, SJL, sleep debt (SD), and food timing were associated with an IBD specific complications and a lower quality of life. Overall, 191 subjects (115 IBD subjects and 76 healthy controls (HC)) completed the Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), Munich ChronoType Questionnaire (MCTQ), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and a structured Food Timing Questionnaire. Later chronotype (by MEQ) was associated with a worse SIBDQ (r = −0.209; P < 0.05). SJL was increased in IBD at 1.32 h ± 1.03 vs. 1.05 h ± 0.97 in HC, P < 0.05, when adjusted for age. SJL (>2 h) was present in 40% of severe/complicated Crohn's patients (fistulizing or structuring Crohn's or history of Crohn's related surgery) compared to only 16% of uncomplicated Crohn's patients (P < 0.05). Sleep debt was increased in IBD subjects compared to HC at 21.90 m ± 25.37 vs. 11.49 m ± 13.58, P < 0.05. IBD subjects with inconsistent breakfast or dinner times had lower SIBDQ scores (4.78 ± 1.28 vs. 5.49 ± 1.02, P < 0.05; 4.95 ± 0.31 vs. 5.42 ± 0.32, P < 0.05 respectively). In summary, later chronotype, and markers of circadian misalignment (social jet lag, sleep debt, and inconsistent meal timing) were associated with IBD disease specific complications and/or lower quality of life.
•Later chronotype was associated with a decreased IBD health related quality of life.•Social jet lag and sleep debt was increased in IBD subjects compared to healthy controls.•In CD, social jet lag and sleep debt were increased in those with more aggressive phenotypes (fistulizing or stricturing) that is well known to be associated with complications, such as surgery.•Inconsistent meal time was associated with a worse IBD specific quality of life.