1
|
Clark LA, Reed R, Corazzini KN, Zhu S, Renn C, Jennifer Klinedinst N. COPD-Related Fatigue: A Scoping Review. Clin Nurs Res 2022; 32:914-928. [PMID: 36540028 DOI: 10.1177/10547738221141224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Millions of people worldwide have chronic obstructive pulmonary disease (COPD), and one of the most common and troublesome symptoms that must be managed is fatigue. While there are existing interventions to address COPD-related fatigue, not all patients experience benefit. A better understanding of the factors associated with COPD-fatigue could elucidate new approaches to address COPD-related fatigue, thereby offering relief to a greater number of patients. The purpose of this review was to identify the physiologic, psychologic, and situational factors associated with COPD-related fatigue. A total of four databases, PubMed, CINAHL, Scopus, and Google Scholar, were searched. Those that were peer reviewed, in English, and published between 2000 and 2021, were included in the review. A total of 25 articles were included in this scoping review. The following factors were related to fatigue in COPD: dyspnea, pain, anxiety, depression, and sleep. Fatigue is a debilitating symptom with factors influential to the symptom and outcomes. Research is indicated to explore targeted and personalized interventions addressing the factors related to fatigue to mitigate this widespread symptom.
Collapse
Affiliation(s)
- Lindsey A. Clark
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Robert Reed
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Cynthia Renn
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | | |
Collapse
|
2
|
Zhang J, Yu S, Zhao G, Jiang X, Zhu Y, Liu Z. Associations of chronic diarrheal symptoms and inflammatory bowel disease with sleep quality: A secondary analysis of NHANES 2005-2010. Front Neurol 2022; 13:858439. [PMID: 36090851 PMCID: PMC9449577 DOI: 10.3389/fneur.2022.858439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Poor sleep quality is highly prevalent in patients with chronic diarrheal symptoms or inflammatory bowel disease (IBD). This study aimed to evaluate the associations of chronic diarrheal symptoms and IBD with sleep quality in the general US population. Methods 14,696 adults (≥20 years) from the National Health and Nutrition Examination Survey (2005-2010) were included in the study. Chronic diarrheal symptoms and IBD were defined by self-reports. Sleep quality was assessed by sleep disorder, sleep trouble, and sleep duration. Multivariable logistic regression models were used to examine the associations. Results After adjustment of a series of covariates, we found that participants with chronic diarrheal symptoms or IBD had higher odds of sleep disorder [chronic diarrheal symptoms: odds ratio (OR) = 1.20, 95% confidence interval (CI) = 1.04-1.38; IBD: OR = 3.86, 95% CI = 1.92-7.77] and sleep trouble (chronic diarrheal symptoms: OR = 1.19, 95% CI = 1.09-1.30; IBD: OR = 2.32, 95% CI = 1.30-4.14), respectively. Sleep duration for participants with IBD was significantly shorter than that for those without IBD (β = -0.39, 95% CI = -0.78 to 0.01, P = 0.045). Subgroup analyses revealed that the associations of chronic diarrheal symptoms and IBD with sleep disorder and sleep trouble were more pronounced among women. Conclusions In this large sample of US adults, we found that chronic diarrheal symptoms and IBD were significantly associated with sleep quality, particularly in women. The findings highlight the importance of managing bowel health to promote high quality of sleep; and thus, improve quality of life in this subpopulation.
Collapse
Affiliation(s)
- Jingyun Zhang
- Center for Clinical Big Data and Analytics, Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Senhai Yu
- Jinhua Town Community Health Service Center, Hangzhou, China
| | - Gang Zhao
- Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaoyan Jiang
- Key Laboratory of Arrhythmias, Ministry of Education, Department of Pathology and Pathophysiology, School of Medicine, Tongji University, Shanghai, China
| | - Yimin Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics, Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
3
|
Chen M, Peng WY, Tang TC, Zheng H. Differential Sleep Traits Have No Causal Effect on Inflammatory Bowel Diseases: A Mendelian Randomization Study. Front Pharmacol 2021; 12:763649. [PMID: 34916940 PMCID: PMC8669049 DOI: 10.3389/fphar.2021.763649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Previous studies suggested an association of sleep disorders with inflammatory bowel disease (IBD) and indicated that using pharmacological treatments for the modulation of circadian rhythms might prevent IBD pathogenesis or aggravation, but whether the effect of sleep traits on IBD was causal is inconclusive and, therefore, prevents drug repurposing based on the previous studies. We aimed to examine the causal effect of different sleep traits on the pathogenesis of IBD. Methods: Genetic instruments for sleep traits were selected from the largest GWAS studies available in the UK Biobank (n = 449,734) and the 23andMe Research (n = 541,333). A two-sample Mendelian randomization (MR) study was conducted to examine the association of the genetic instruments with IBD (12,882 cases and 21,770 controls), ulcerative colitis (6,968 cases, 20,464 controls), and Crohn's disease (5,956 cases and 14,927 controls). We applied the inverse-variance weighted (IVW) method to estimate causal effects, and we used the weighted median and MR-Egger method for sensitivity analyses. Results: We found that sleep duration (OR, 1.00, 95% CI 1.00-1.01), short sleep duration (OR, 1.07, 95% CI 0.41-2.83), morningness (OR, 1.05, 95% CI 0.87-1.27), daytime napping (OR, 1.64, 95% CI 0.62-4.4), frequent insomnia (OR, 1.17, 95% CI 0.8-1.72), any insomnia (OR, 1.17, 95% CI 0.69-1.97), and snoring (OR, 0.31, 95% CI 0.06-1.54) had no causal effect on IBD, and these sleep traits had no causal effect on ulcerative colitis and Crohn's disease either. Most of the sensitivity analyses showed consistent results with those of the IVW method. Conclusion: Our MR study did not support the causal effect of sleep traits on IBD. Pharmacological modulation of circadian rhythms for the prevention of IBD pathogenesis was unwarranted.
Collapse
Affiliation(s)
- Min Chen
- Department of Colorectal Diseases, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wen-Yan Peng
- The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tai-Chun Tang
- Department of Colorectal Diseases, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hui Zheng
- The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
4
|
The Association between Temperament, Chronotype, Depressive Symptoms, and Disease Activity among Patients with Inflammatory Bowel Disease-A Cross-Sectional Pilot Study. Life (Basel) 2021; 11:life11121347. [PMID: 34947878 PMCID: PMC8706576 DOI: 10.3390/life11121347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/29/2021] [Accepted: 12/04/2021] [Indexed: 11/18/2022] Open
Abstract
The psychological aspect may play an important role in ulcerative colitis (UC) and Crohn’s disease (CD). The aims of this study were to explore the differences between patients with UC and CD regarding chronotype, temperament and depression, and to assess the psychological factors mentioned as predictors of disease activity. In total, n = 37 patients with UC and n = 47 patients with CD were included in the study. They underwent a clinical assessment, including the Mayo score or Crohn Disease Activity Index (CDAI), and completed questionnaires: a sociodemographic survey, Formal Characteristics of Behavior–Temperament Inventory (FCB-TI), Chronotype Questionnaire (CQ), and the Beck Depression Index II (BDI). The Sensory Sensitivity score was higher among patients with CD than UC (p = 0.04). The emotional reactivity and endurance scores were higher among women than men with CD (p = 0.028 and p = 0.012 respectively). CQ Morningness–Eveningness (ME) correlated with Endurance (p = 0.041), Emotional Reactivity (p = 0.016), and Activity (p = 0.004). ME correlated with Rhythmicity among CD patients (p = 0.002). The Mayo score was predicted by Perseverance. The CDAI score was predicted by the BDI score. The pattern of the relationship between chronotype and temperament may differentiate patients with UC and CD. Personal disposition may play a role in the clinical assessment of patients with IBD.
Collapse
|
5
|
Truyens M, De Ruyck E, Gonzales GB, Bos S, Laukens D, De Vos M. Prevalence of Fatigue and Unrecognized Depression in Patients with Inflammatory Bowel Disease in Remission under Immunosuppressants and Biologicals. J Clin Med 2021; 10:jcm10184107. [PMID: 34575218 PMCID: PMC8471955 DOI: 10.3390/jcm10184107] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Although highly prevalent among inflammatory bowel disease (IBD) patients, fatigue remains an unmet clinical need. The aim was to describe the prevalence of fatigue in an IBD population in remission and identify factors associated with fatigue. Methods: IBD patients in clinical and biochemical remission under treatment with immunomodulators or biologicals were included. Fatigue, physical tiredness and depression were assessed using the fatigue Visual Analogue Scale (fVAS), the Shortened Fatigue Questionnaire (SFQ) and the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR), respectively. Relevant clinical and biochemical parameters were included in regression analyses to identify factors associated with physical fatigue. Results: In total, 157 IBD patients were included. Up to 45.9% of patients reported fatigue, physical tiredness was observed in 51% and depression in 10.8%. The majority of patients with subclinical depression were fatigued. Female sex (OR = 4.17 [1.55–6.78], p = 0.002) was independently associated with physical fatigue. Transferrin saturation (OR = −0.11 [−0.22–−0.007], p = 0.037) and treatment with adalimumab (compared to infliximab, OR = −3.65 [−7.21–−0.08], p = 0.045) entailed a lower risk of fatigue. Conclusion: Fatigue is observed in about half of IBD patients in remission and can be a symptom of underlying undetected depression. Sex, transferrin saturation and medication were identified as independent risk factors.
Collapse
Affiliation(s)
- Marie Truyens
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (M.T.); (S.B.); (M.D.V.)
- VIB Center for Inflammation Research, 9052 Ghent, Belgium
- Department of Gastroenterology, University Hospital Ghent, 9000 Ghent, Belgium
| | - Elodie De Ruyck
- Department of Gastroenterology, AZ Nikolaas, 9100 Sint-Niklaas, Belgium;
| | - Gerard Bryan Gonzales
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition and Health, Wageningen University, 6700 WE Wageningen, The Netherlands;
| | - Simon Bos
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (M.T.); (S.B.); (M.D.V.)
- VIB Center for Inflammation Research, 9052 Ghent, Belgium
| | - Debby Laukens
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (M.T.); (S.B.); (M.D.V.)
- VIB Center for Inflammation Research, 9052 Ghent, Belgium
- Correspondence:
| | - Martine De Vos
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (M.T.); (S.B.); (M.D.V.)
| |
Collapse
|
6
|
Yang PL, Burr RL, de la Iglesia HO, Buchanan DT, Ward TM, Landis CA, Heitkemper MM. Associations between chronotype, social jetlag, and weekday sleep in women with irritable bowel syndrome. Chronobiol Int 2021; 38:742-752. [PMID: 33612026 DOI: 10.1080/07420528.2021.1885430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Sleep deficiency is well-documented in individuals with irritable bowel syndrome (IBS). Sleep deficiency includes poor sleep quality and an inadequate amount of sleep, and is a modifiable risk factor for IBS symptom exacerbations. Prior studies in other populations have identified chronotype and social jetlag (SJL) as important determinants of sleep outcomes. However, chronotype and SJL have not been examined in women with IBS. We used multiple linear regression analyses to determine whether chronotype and SJL are associated with sleep outcomes during weekdays among women with IBS predominant constipation (IBS-C), IBS with predominant diarrhea (IBS-D), and healthy control (HC) women. This sample included 62 women with IBS (IBS-C = 29, IBS-D = 33) and 58 HC women who completed a 28-day daily diary from two study cohorts. The average age of the participants was 30.1 (SD 7.2) years. Chronotype was estimated from daily diary data with the average mid-sleep time on weekends (MSWwe). SJL was calculated by subtracting the average mid-sleep time on weekdays from MSWwe. Sleep outcomes included diary assessments of sleep quality, sleep need met, and restorative sleep during weekdays. In HCs, later chronotype was predictive of lower sleep quality (β = -0.19, p < .01), a perception of sleep need not met (β = -0.17, p < .001), and a less restorative sleep during weekdays (β = -0.15, p = .073), whereas SJL was not associated with sleep outcomes. Similar to HCs, earlier chronotypes in women with IBS-C reported better sleep quality and more sufficient sleep need met and restorative sleep during weekdays than later chronotypes (all p > .05). Compared to HCs, the relationships of chronotype with weekday sleep outcomes in the women with IBS-D were in the opposite directions (all p < .05). This exploratory study suggests that chronotype expression may reflect the temporal associations of sleep outcomes within IBS bowel pattern predominance subgroups, particularly sleep quality and sleep need met. Additional investigations are warranted to examine whether specific temporal attributes of symptoms and/or symptom severity associated with IBS subgroups contribute to chronotype expression.
Collapse
Affiliation(s)
- Pei-Lin Yang
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA.,School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Robert L Burr
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA.,Office of Nursing Research, School of Nursing, University of Washington, Seattle, Washington, USA
| | | | - Diana T Buchanan
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Teresa M Ward
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Carol A Landis
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Margaret M Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| |
Collapse
|
7
|
Starreveld DEJ, Habers GEA, Valdimarsdottir HB, Kessels R, Daniëls LA, van Leeuwen FE, Bleiker EMA. Cancer-related Fatigue in Relation to Chronotype and Sleep Quality in (Non-)Hodgkin Lymphoma Survivors. J Biol Rhythms 2021; 36:71-83. [PMID: 33480295 PMCID: PMC7924108 DOI: 10.1177/0748730420987327] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Cancer-related fatigue has been related to circadian disruptions and lower levels of sleep quality. However, it is unknown whether the circadian phase, which is associated with chronotype and timing of sleep, is related to fatigue after cancer. The aims of this study were to investigate the associations between (1) chronotype and cancer-related fatigue and (2) sleep quality and cancer-related fatigue. In this cross-sectional questionnaire study, 458 (non-)Hodgkin lymphoma survivors (n = 231 female, mean age 49.7 years) completed a Visual Analogue Scale for fatigue (VAS-fatigue) from 0 (no fatigue) to 10 (worst imaginable fatigue), the Munich Chronotype Questionnaire (MCTQ), and the Pittsburgh Sleep Quality Index (PSQI) between October 2018 and July 2019. A hierarchical linear regression analysis was used to evaluate the associations between the dependent variable fatigue and chronotype (based on early, intermediate, or late average midsleep) in Model 1, and fatigue and sleep quality in Model 2. The results showed no indications for an association between chronotype and fatigue (all p values ≥ 0.50). There were associations between two (out of seven) aspects of sleep quality and fatigue: subjective sleep quality (p < 0.001) and daily dysfunctioning (p < 0.001). Therefore, it is more likely that fatigue is associated with self-reported sleep quality rather than with chronotype. However, experimental studies with objective, physiological data on circadian phase and sleep quality are necessary to confirm the conclusions of this cross-sectional study.
Collapse
Affiliation(s)
- Daniëlle E J Starreveld
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - G Esther A Habers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | | | - Rob Kessels
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Laurien A Daniëls
- Department of Radiotherapy, Amsterdam UMC, Amsterdam, the Netherlands
| | - Flora E van Leeuwen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Eveline M A Bleiker
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Family Cancer Clinic, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
8
|
The circadian clock and inflammation: A new insight. Clin Chim Acta 2020; 512:12-17. [PMID: 33242468 DOI: 10.1016/j.cca.2020.11.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022]
Abstract
The circadian clock is a complex cellular mechanism that controls a series of physiological processes, including inflammation. It can directly interact physically with the components of the key inflammatory pathway. Similarly, inflammation can also lead to circadian rhythm disorders, which may further amplify the inflammatory response and aggravate tissue damage. This review offers a structured overview that focusses on the core proteins of the circadian clock and their interactions with inflammatory players, and provides a potential mechanism for the pathological rhythms observed under inflammatory conditions.
Collapse
|
9
|
Kiyotoki S, Nishikawa J, Nagata N, Niikura R, Doyama H, Imagawa A, Hasatani K, Hatta W, Sumiyoshi T, Nebiki H, Nagami Y, Nishida T, Kakushima N, Iguchi M, Tomida H, Inoue T, Kuribayashi S, Narasaka T, Hikichi T, Yada T, Ochiai Y, Furuhashi H, Yoshio T, Mori H, Yamauchi K, Kitamura K, Fujita T, Mabe K, Mikami T, Goto A, Akashi M, Hamamoto Y, Fujishiro M, Sakaida I. Exploration of the characteristics of chronotypes in upper gastrointestinal tract diseases: a multicenter study in Japan. Chronobiol Int 2020; 38:534-542. [PMID: 33059467 DOI: 10.1080/07420528.2020.1830791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Characteristics of the chronotypes of patients with gastrointestinal disease are unknown. We evaluated chronotypes of patients with upper gastrointestinal diseases with the Munich ChronoType Questionnaire (MCTQ). A total of 2027 subjects from 29 institutions in Japan who had undergone esophagogastroduodenoscopy were asked to answer the MCTQ. The subjects' chronotypes were divided into three groups (early, intermediate, and late chronotype) using the sleep-corrected mid-point of sleep on free days (MSFSC) values. According to their endoscopic diagnosis and abdominal symptoms, the subjects were divided into the reflux esophagitis (RE) group, gastroduodenal ulcer (GDU) group, upper gastrointestinal carcinoma (CA) group, functional dyspepsia (FD) group, non-FD group, and control group. In total, 1128 subjects were eligible for the analysis. The MSFSC (average ± standard deviation, clock hours, h) of each disease group was as follows: control group: 02.51 ± 1.22, non-FD group: 02.69 ± 1.14, FD group: 02.91 ± 1.19, RE group: 02.58 ± 1.05, GDU group: 02.47 ± 1.31, and CA group: 02.11 ± 1.08 h. Compared to the control group, the rate of late chronotype of the FD group significantly increased to 33.3%, whereas that of early chronotype of the CA group significantly increased to 38.3% (P = .0177 and 0.0036, respectively). In both the FD and CA groups, chronotype was the independent factor related to the diseases. The adjusted odds ratio of late chronotype to early chronotype was 3.01 [95% CI, 1.23-7.35] in the FD group and 0.44 [95% CI, 0.23-0.85] in the CA group. In conclusion, late chronotype was common in patients with FD, and early chronotype was common in patients with upper gastrointestinal carcinoma.
Collapse
Affiliation(s)
- Shu Kiyotoki
- Faculty of Laboratory Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Jun Nishikawa
- Department of Gastroenterology, Shuto General Hospital, Yanai, Japan
| | - Naoyoshi Nagata
- Department of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan.,Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryota Niikura
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Hisashi Doyama
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | | | - Kenkei Hasatani
- Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan
| | - Waku Hatta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Hiroko Nebiki
- Department of Gastroenterology, Osaka City General Hospital, Osaka, Japan
| | - Yasuaki Nagami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Tsutomu Nishida
- Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Naomi Kakushima
- Division of Endoscopy, Shizuoka Cancer Center, Suntougun, Japan
| | - Mikitaka Iguchi
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hideomi Tomida
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Takuya Inoue
- Department of Gastroenterology and Hepatology, Osaka General Medical Center, Osaka, Japan
| | - Shiko Kuribayashi
- Department of Gastroenterology and Hepatology, Gunma University Hospital, Maebashi, Japan
| | - Toshiaki Narasaka
- Department of Gastroenterology, University of Tsukuba, Tsukuba, Japan
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Tomoyuki Yada
- Department of Gastroenterology & Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Yorinari Ochiai
- Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
| | - Hiroto Furuhashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Toshiyuki Yoshio
- Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
| | - Hideki Mori
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kenji Yamauchi
- Department of Gastroenterology, Mitoyo General Hospital, Kannonji, Japan
| | - Kazuya Kitamura
- Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan
| | - Tomoki Fujita
- Department of Medical Gastroenterology, Otaru-Ekisaikai Hospital, Otaru, Japan
| | - Katsuhiro Mabe
- Junpukai Health Maintenance Center Kurashiki, Kurashiki, Japan
| | - Tatsuya Mikami
- Division of Endoscopy, Hirosaki University Hospital, Hirosaki, Japan
| | - Atsushi Goto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Makoto Akashi
- The Research Institute for Time Studies, Yamaguchi University, Yamaguchi, Japan
| | - Yoshihiko Hamamoto
- Department of Information Science and Engineering, Yamaguchi University Graduate School of Sciences and Technology for Innovation, Ube, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Isao Sakaida
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| |
Collapse
|
10
|
Nocerino A, Nguyen A, Agrawal M, Mone A, Lakhani K, Swaminath A. Fatigue in Inflammatory Bowel Diseases: Etiologies and Management. Adv Ther 2020; 37:97-112. [PMID: 31760611 PMCID: PMC6979464 DOI: 10.1007/s12325-019-01151-w] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Indexed: 12/11/2022]
Abstract
Fatigue is a burdensome, multidimensional, and multifactorial symptom that is associated with a wide array of chronic illnesses, specifically occurring in nearly 50% of patients with inflammatory bowel disease (IBD). Although common, given its subjective nature, physicians often under-recognize and undertreat this debilitating symptom. There are multiple etiologies that can contribute to fatigue in patients with IBD, including disease activity, anemia, medications, psychosomatic symptoms, and alterations to the gut–brain axis. The management of fatigue in IBD can be challenging, as it is often times multifaceted. In this review, we summarize the available tools for the diagnosis and measurement of fatigue, discuss etiologies, and make recommendations for their management. We identify knowledge gaps for the workup and treatment of fatigue and propose an algorithm to aid physicians in the evaluation and management of fatigue in this unique population. However, future research is needed to address several areas of knowledge deficits and improve the management of fatigue in IBD.
Collapse
Affiliation(s)
| | - Andrew Nguyen
- Lenox Hill Hospital, Northwell Health System, New York, NY, USA
| | - Manasi Agrawal
- Department of Gastroenterology, Mount Sinai Hospital, New York, NY, USA
| | - Anjali Mone
- Lenox Hill Hospital, Northwell Health System, New York, NY, USA
| | - Komal Lakhani
- Lenox Hill Hospital, Northwell Health System, New York, NY, USA
| | - Arun Swaminath
- Lenox Hill Hospital, Northwell Health System, New York, NY, USA.
| |
Collapse
|
11
|
Voigt RM, Forsyth CB, Keshavarzian A. Circadian rhythms: a regulator of gastrointestinal health and dysfunction. Expert Rev Gastroenterol Hepatol 2019; 13:411-424. [PMID: 30874451 PMCID: PMC6533073 DOI: 10.1080/17474124.2019.1595588] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Circadian rhythms regulate much of gastrointestinal physiology including cell proliferation, motility, digestion, absorption, and electrolyte balance. Disruption of circadian rhythms can have adverse consequences including the promotion of and/or exacerbation of a wide variety of gastrointestinal disorders and diseases. Areas covered: In this review, we evaluate some of the many gastrointestinal functions that are regulated by circadian rhythms and how dysregulation of these functions may contribute to disease. This review also discusses some common gastrointestinal disorders that are known to be influenced by circadian rhythms as well as speculation about the mechanisms by which circadian rhythm disruption promotes dysfunction and disease pathogenesis. We discuss how knowledge of circadian rhythms and the advent of chrono-nutrition, chrono-pharmacology, and chrono-therapeutics might influence clinical practice. Expert opinion: As our knowledge of circadian biology increases, it may be possible to incorporate strategies that take advantage of circadian rhythms and chronotherapy to prevent and/or treat disease.
Collapse
Affiliation(s)
- Robin M Voigt
- Rush Department of Medicine, Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, IL, USA
| | - Christopher B Forsyth
- Rush Department of Medicine, Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, IL, USA
| | - Ali Keshavarzian
- Rush Department of Medicine, Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
12
|
Gombert M, Carrasco-Luna J, Pin-Arboledas G, Codoñer-Franch P. The connection of circadian rhythm to inflammatory bowel disease. Transl Res 2019; 206:107-118. [PMID: 30615844 DOI: 10.1016/j.trsl.2018.12.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/25/2018] [Accepted: 12/16/2018] [Indexed: 02/07/2023]
Abstract
Inflammatory bowel disease (IBD) comprises a group of chronic, immune system-mediated inflammatory diseases that primarily affect the gastrointestinal tract. The pathogenesis of the intestinal lesions in IBD remains elusive, but the inflammation process could be the result of dysfunction of the innate and adaptive immune systems induced by genetic and environmental factors. In recent years, research has demonstrated a connection between environmental stressors that can influence day-night variations, also called circadian rhythms, and digestive health. In this review, we focus on alterations in the complex interactions between intestinal mucosa, microbial factors, and the immune response in the intestinal milieu. We introduce the mechanisms that establish circadian rhythms and their regulation by the circadian rhythm genes. Evidence of circadian variation in the defense mechanisms of the intestine and its implication in the maintenance of a healthy microbiota are presented. Disruption of the circadian system can increase the activity of the gut immune system and the release of inflammatory factors. The link between chronodisruption or circadian rhythm impairment and IBD demonstrated by experimental and clinical studies illustrates the potential impact of circadian rhythms on treatment of these diseases. Future studies that investigate aspects of this subject are warranted.
Collapse
Affiliation(s)
- Marie Gombert
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain; Department of Biotechnology, University of La Rochelle, La Rochelle, France
| | - Joaquín Carrasco-Luna
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain; Department Experimental Sciences, Catholic University of Valencia, Valencia, Spain
| | - Gonzalo Pin-Arboledas
- Department of Pediatrics, Pediatric Sleep Unit, Hospital Quironsalud, Valencia, Spain
| | - Pilar Codoñer-Franch
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain; Department of Pediatrics, Dr. Peset University Hospital, Valencia, Spain.
| |
Collapse
|
13
|
|
14
|
Ballou S, Alhassan E, Hon E, Lembo C, Rangan V, Singh P, Hirsch W, Sommers T, Iturrino J, Nee J, Lembo A. Sleep Disturbances Are Commonly Reported Among Patients Presenting to a Gastroenterology Clinic. Dig Dis Sci 2018; 63:2983-2991. [PMID: 30094624 DOI: 10.1007/s10620-018-5237-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 08/01/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Poor sleep quality is common among patients with gastrointestinal (GI) disorders. However, few studies have assessed the presence of insomnia or reported circadian preferences and none have directly compared sleep between common GI conditions. AIMS To compare clinical sleep characteristics in patients presenting to a tertiary care GI clinic for irritable bowel syndrome (IBS), functional dyspepsia (FD), inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), and celiac disease (CD). METHODS Validated sleep measures were administered to consecutive patients if they were diagnosed with IBS, IBD in clinical remission, CD, FD, or GERD. Healthy Controls (HCs) with no reported GI diagnoses or symptoms were also recruited. RESULTS A total of 212 eligible respondents completed this survey, 161 GI clinic patients (IBS (n = 48), GERD (n = 29), IBD in clinical remission (n = 44), CD (n = 40)), and 41 HCs. Only, 10 respondents had a diagnosis of FD, and these were excluded. The IBS group had the highest frequency of poor sleep (72%) followed by CD (61%), GERD (60%), IBD (54%), and HC (39%). IBS patients also had the highest frequency of clinical insomnia (51%), followed by GERD (37%), CD (35%), IBD (27%), and HC (18%). 40% of IBS patients reported taking sleep medications at least once per week, compared to 32% of GERD, 23% IBD, 13% CD, and 15% HC. CONCLUSIONS Patients presenting to a tertiary care GI clinic report poorer sleep than healthy controls. In general, patients with IBS report the highest rates of sleep difficulties compared to patients with other diagnoses.
Collapse
Affiliation(s)
- Sarah Ballou
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - Eaman Alhassan
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - Elise Hon
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - Cara Lembo
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - Vikram Rangan
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - Prashant Singh
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - William Hirsch
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - Thomas Sommers
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - Johanna Iturrino
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - Judy Nee
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA
| | - Anthony Lembo
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA, 02215, USA.
| |
Collapse
|
15
|
Chakradeo PS, Keshavarzian A, Singh S, Dera AE, Esteban JPG, Lee AA, Burgess HJ, Fogg L, Swanson GR. Chronotype, social jet lag, sleep debt and food timing in inflammatory bowel disease. Sleep Med 2018; 52:188-195. [PMID: 30243610 DOI: 10.1016/j.sleep.2018.08.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 12/29/2022]
Abstract
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.
Collapse
Affiliation(s)
- Prachi S Chakradeo
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
| | - Ali Keshavarzian
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
| | - Shubha Singh
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
| | - Akram E Dera
- Internal Medicine, Greater Baltimore Medical Center, Towson, MD, United States.
| | | | - Alice A Lee
- Rush University Medical Center, Chicago, IL, 60612, United States.
| | - Helen J Burgess
- Biological Rhythms Research Laboratory, Rush University Medical Center, Chicago, IL, 60612, United States.
| | - Louis Fogg
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
| | - Garth R Swanson
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
| |
Collapse
|