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Sleep duration affects risk for ulcerative colitis: a prospective cohort study.
Clin Gastroenterol Hepatol 2014; 12(11):1879-86CG

Abstract

BACKGROUND & AIMS

Sleep deprivation is associated with production of inflammatory cytokines. Disturbed sleep quality has been associated with increased risk of disease flare in patients with Crohn's disease (CD) or ulcerative colitis (UC). However, the association between sleep and risk of incident CD and UC has not been previously examined.

METHODS

We conducted a prospective study of women who were enrolled in the Nurses' Health Study (NHS) I since 1976 and NHS II since 1989 and followed through detailed biennial questionnaires with >90% follow-up. We examined the association of sleep duration reported in 1986 in NHS I and 2001 in NHS II with incident CD and UC, diagnosed through 2010, in NHS I and 2009 in NHS II. Cox proportional hazards models adjusting for potential confounders were used to calculate hazard ratios and 95% confidence intervals (CIs).

RESULTS

Among 151,871 women, we confirmed 191 cases of CD (incidence, 8/100,000 person-years) and 230 cases of UC (incidence, 10/100,000 person-years) over 2,292,849 person-years. Compared with women with reported usual sleep durations of 7-8 h/day (incidence, 8/100,000 person-years), women with reported sleep duration <6 h/day (11/100,000 person-years) or >9 h/day (20/100,000 person-years) had a higher incidence of UC (P < .05). The multivariate hazard ratios for UC were 1.51 (95% CI, 1.10-2.09) for sleep durations <6 h/day and 2.05 (95% CI, 1.44-2.92) for sleep durations >9 h/day, compared with sleep durations of 7-8 h/day. In contrast, sleep duration did not modify risk of CD. Duration of rotating night shift work was not associated with CD or UC.

CONCLUSIONS

On the basis of data from the NHS I and II, less than 6 hours sleep/day and more than 9 hours sleep/day are each associated with an increased risk of UC. Further studies are needed to evaluate sleep as a modifiable risk factor in the pathogenesis and progression of IBD.

Authors+Show Affiliations

Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: aananthakrishnan@partners.org.Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.Division of Gastroenterology and Nutrition, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts.Division of Gastroenterology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.Division of Gastroenterology and Nutrition, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts.Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24780288

Citation

Ananthakrishnan, Ashwin N., et al. "Sleep Duration Affects Risk for Ulcerative Colitis: a Prospective Cohort Study." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 12, no. 11, 2014, pp. 1879-86.
Ananthakrishnan AN, Khalili H, Konijeti GG, et al. Sleep duration affects risk for ulcerative colitis: a prospective cohort study. Clin Gastroenterol Hepatol. 2014;12(11):1879-86.
Ananthakrishnan, A. N., Khalili, H., Konijeti, G. G., Higuchi, L. M., de Silva, P., Fuchs, C. S., ... Chan, A. T. (2014). Sleep duration affects risk for ulcerative colitis: a prospective cohort study. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 12(11), pp. 1879-86. doi:10.1016/j.cgh.2014.04.021.
Ananthakrishnan AN, et al. Sleep Duration Affects Risk for Ulcerative Colitis: a Prospective Cohort Study. Clin Gastroenterol Hepatol. 2014;12(11):1879-86. PubMed PMID: 24780288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sleep duration affects risk for ulcerative colitis: a prospective cohort study. AU - Ananthakrishnan,Ashwin N, AU - Khalili,Hamed, AU - Konijeti,Gauree G, AU - Higuchi,Leslie M, AU - de Silva,Punyanganie, AU - Fuchs,Charles S, AU - Richter,James M, AU - Schernhammer,Eva S, AU - Chan,Andrew T, Y1 - 2014/04/26/ PY - 2014/03/04/received PY - 2014/04/04/accepted PY - 2014/5/1/entrez PY - 2014/5/2/pubmed PY - 2015/7/15/medline KW - Circadian Clock KW - Epidemiology KW - Inflammation KW - Population KW - Risk Factor SP - 1879 EP - 86 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 12 IS - 11 N2 - BACKGROUND & AIMS: Sleep deprivation is associated with production of inflammatory cytokines. Disturbed sleep quality has been associated with increased risk of disease flare in patients with Crohn's disease (CD) or ulcerative colitis (UC). However, the association between sleep and risk of incident CD and UC has not been previously examined. METHODS: We conducted a prospective study of women who were enrolled in the Nurses' Health Study (NHS) I since 1976 and NHS II since 1989 and followed through detailed biennial questionnaires with >90% follow-up. We examined the association of sleep duration reported in 1986 in NHS I and 2001 in NHS II with incident CD and UC, diagnosed through 2010, in NHS I and 2009 in NHS II. Cox proportional hazards models adjusting for potential confounders were used to calculate hazard ratios and 95% confidence intervals (CIs). RESULTS: Among 151,871 women, we confirmed 191 cases of CD (incidence, 8/100,000 person-years) and 230 cases of UC (incidence, 10/100,000 person-years) over 2,292,849 person-years. Compared with women with reported usual sleep durations of 7-8 h/day (incidence, 8/100,000 person-years), women with reported sleep duration <6 h/day (11/100,000 person-years) or >9 h/day (20/100,000 person-years) had a higher incidence of UC (P < .05). The multivariate hazard ratios for UC were 1.51 (95% CI, 1.10-2.09) for sleep durations <6 h/day and 2.05 (95% CI, 1.44-2.92) for sleep durations >9 h/day, compared with sleep durations of 7-8 h/day. In contrast, sleep duration did not modify risk of CD. Duration of rotating night shift work was not associated with CD or UC. CONCLUSIONS: On the basis of data from the NHS I and II, less than 6 hours sleep/day and more than 9 hours sleep/day are each associated with an increased risk of UC. Further studies are needed to evaluate sleep as a modifiable risk factor in the pathogenesis and progression of IBD. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/24780288/Sleep_duration_affects_risk_for_ulcerative_colitis:_a_prospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(14)00627-2 DB - PRIME DP - Unbound Medicine ER -