Schneekloth, Melanie

Abstract Introduction Individuals with ostomies commonly report poor sleep quality years after ostomy surgery; however, little is known about the trajectory of insomnia and objective sleep characteristics in the early postoperative period. The purpose of this study was to describe the trajectory of insomnia and sleep characteristics in the first 3 months following ileostomy surgery. Methods We conducted a prospective, observational feasibility study of adults (18-65 years) undergoing ileostomy surgery. Sleep characteristics were obtained via Garmin smartwatches (vívosmart® 5) worn from 2 weeks to 3 months postoperatively. The Insomnia Severity Index (ISI) was used to elicit insomnia severity perioperatively and at postoperative months 1, 2, and 3. Descriptive and univariate statistics were used. Results We enrolled 22 participants [Mean age 41.55 years (SD 10.77), 10 female (45.5%), 19 White (86.4%), 9 colorectal cancer (40.9%), and 8 inflammatory bowel disease (36.3%)]. There was little change in insomnia severity from the perioperative period (mean = 9.95, SD 5.57) to 3 months after surgery (∆ = 0.76). At the time of ostomy surgery, most participants (n = 13, 59.1%) had insomnia (ISI≥8). Fifteen participants completed the postoperative surveys. Of those, 2 participants (13.3%) experienced resolution of insomnia symptoms, 3 participants (20%) continued to report no insomnia symptoms, 5 participants (33.3%) developed new insomnia symptoms, and 5 (33.3%) experienced persistent insomnia symptoms. There was little change in sleep duration (m = 462.10 min, SD = 79.07, ∆ = -24.1), deep sleep (m = 81.21 min, SD = 16.97, ∆ = -8.01), light sleep (m = 297.93 min, SD = 44.26, ∆ = -3.93), REM sleep (m = 82.82 min, SD = 44.50, ∆ = -12.02), wake after sleep onset (m = 51.87 min, SD = 29.93, ∆ = -3.05), or sleep score out of 100 (m = 59.15, SD = 11.83, ∆ = -1.74) from month 1 to month 3 after surgery. Conclusion Individuals undergoing ileostomy surgery experience symptoms of insomnia which often persist throughout the early postoperative period. Future research should explore the impact of insomnia on ostomy outcomes and should test interventions to treat insomnia in the early postoperative period. Support (if any) LabfrontXGarmin

Individuals with inflammatory bowel disease (IBD) experience overlooked deficits in objectively measured cognitive functioning; however, there is limited knowledge about self-reported cognitive symptoms in this group. Sleep characteristics, such as insomnia, poor sleep quality, or fragmented sleep, may be key modifiable factors that are associated with cognitive symptoms among individuals with IBD. This study aimed to describe cognitive symptoms and examine the relationship between these symptoms and sleep characteristics among adults with IBD. We conducted a descriptive, cross-sectional study using the Pittsburgh Sleep Quality Index, wrist actigraphy, the Insomnia Severity Index, and the FACT-Cog Perceived Cognitive Impairments subscale. Bivariate statistics were used to evaluate relationships between variables. The sample included 83 participants (mean age 40.44 years [standard deviation 10.7], 71% female). Over 77% ( n = 60) had poor self-reported sleep quality, and 69.5% ( n = 57) had clinically meaningful insomnia. The most frequently reported cognitive symptoms (experienced two or more times a week) were trouble concentrating (51.3%), forgetting names (43.8%), forgetting intended tasks (38.9%), and slow thinking (37.6%). Insomnia severity was moderately correlated with three out of the four most common cognitive symptoms (trouble concentrating: r s = .51, p < .01; forgetting intended tasks: r s = .38, p < .01; slow thinking: r s = .46, p < .01). Future research is needed to examine relationships between objective cognitive measures and sleep characteristics and to test the effects of insomnia treatment on daytime cognitive symptoms in this complex patient population.

Abstract Introduction The majority of adults with inflammatory bowel disease (IBD) experience disability which is not fully explained by disease activity. Up to 80% of adults with IBD experience poor sleep health, which is associated with disability in other populations; however, the relationship between disability and sleep health among patients with IBD is largely unexamined. The purpose of this study was to compare the sleep health characteristics of those with and without IBD-related disability. Methods We recruited adults (18 to 59 years old) with IBD from a single academic medical center from 2022 to 2024. We measured disease activity using the Manitoba IBD Index and sleep using the PROMIS Sleep Disturbance and PROMIS Sleep-Related Impairment scales, the Insomnia Severity Index, and 14 days of wrist-worn actigraphy (Phillips Spectrum Plus, Phillips Respironics). We asked participants how many days they missed or had at least 50% reduced productivity in paid work or household work or missed leisure activities in the last 3 months related to their IBD. Disability was defined as missing six or more day over three months. We conducted bivariate analyses and logistic regressions to study associations. Results Among 83 adults with IBD [mean age = 40.4 years (SD 10.7), 59 (71.1%) were female, 56 (71.1%) had Crohn’s disease], and 49 (62.0%) had IBD-related disability. Patients with disability had more severe sleep disturbance (56.4 vs. 51.0, p &lt;.001), sleep-related impairment (58.3 vs 50.3, p &lt;.001), more severe insomnia (12.7 vs. 9.4, p =.029), and actigraph-measured higher wake after sleep onset (41.6 minutes vs. 34.0 minutes, p = 0.012) and lower sleep efficiency (85.1% vs. 87.9%, p = 0.032) compared to those without disability. After controlling for age and disease activity, sleep-related impairment (OR = 1.1, 95% CI 1.03, 1.15) was independently associated with disability. Conclusion Patients with IBD-related disability experience poor sleep health. Sleep related daytime impairment uniquely contributed to disability when controlling for disease activity. Sleep interventions need to be tested in adults with IBD to determine if they are effective at addressing disability in this population. Support (if any) Mayo Clinic Bonner Fund