Taha Qazi, MD: The Role of Sleep in Diverse Populations With IBD

In an interview MD Magazine® at ACG 2019, Taha Qazi, MD, associate staff at Cleveland Clinic, summarizes his research comparing objective sleep parameters assessed by wrist actigraphy in minority inflammatory bowel disease (IBD) patients compared to Caucasian IBD patients.

MD Magazine®: What was discuss the impetus for this study?

Qazi: We found that patients with inflammatory bowel disease have poor sleep. We're not quite sure why that occurred, but there appears to be a bi-directional relationship between sleep and disease activity, meaning that disease activity perpetuates poor sleep, but poor sleep also worsens disease activity to a certain degree. We found also that patients who are minorities tend to have poorer sleep. But there been no really good studies looking at sleep patterns and both objective and subjective findings of sleep in patients who are minorities with inflammatory bowel disease compared with non-minorities with inflammatory bowel disease.

There have been some data showing that minorities have poor sleep patterns and this may be a reason why there're such disparities in health status among some minorities versus non-minorities in our patients.

MD Magazine®: Can you summarize your key findings?

Qazi: After controlling for disease activity and certain medications, we found that minority status was significantly associated with objective parameters of poor sleep, as measured by a wrist actigraph, meaning that patients that were minorities, mainly African Americans or blacks and non-Caucasian Hispanics, had poorer sleep, had more fragmented sleep, and were waking up more often than Caucasians who had IBD. Interestingly, their subjective patterns were not different. We found that this is only true for the objective measurements asleep on a wrist actigraphy. So just think that the surveys that we use often in our clinic are probably not capturing the sleep patterns of our patients with IBD, which is something that's also been discussed in the past.

MD Magazine®: What is the biggest takeaway for clinicians?

Qazi: I think the biggest lesson learned is that, in many ways, minorities with IBD have suggested they often have a poorer disease course. Studies have suggested that the main areas we're finding these poor disease course indices are usually in the subjective indices of disease activity on Harvey-Bradshaw index. There may be a concern that we're not appropriately addressing complaints or questions regarding sleep, depression, psychosocial issues, in our minority patients with inflammatory bowel disease, and that having a culturally centered approach for these patients is something that, moving forward, will be very important. More importantly, I think it may suggest that poor sleep is universal in our inflammatory bowel disease patients, and that addressing this key component in their psychosocial issues, it'd be helpful in sort of not only promoting good good health in terms of IBD but general wellness and being.

The poster, “Disparities in Objective Sleep Quality as Assessed by Wrist Actigraphy in Minority Patients With Inflammatory Bowel Disease,” was presented Tuesday, October 29, 2019, at ACG 2019 in San Antonio,Texas.