Sleep tracking and sleep hygiene counseling improve fatigue in pediatric patients with inflammatory bowel disease.

Objectives: While the presence of fatigue and inadequate sleep are well-described in children with inflammatory bowel disease (IBD), little data exist on potential sleep improvement interventions. We aimed to determine if sleep tracking and sleep hygiene counseling can result in sleep behavior change and reduced fatigue in children/adolescents with IBD.

Methods: This was a single-center, prospective, randomized controlled trial. Patients 12-20 years old with IBD, in clinical remission, completed validated Pediatric Quality of Life-Multidimensional Fatigue Scales (PedsQL-MDFS). Those who were found to have impaired sleep/rest fatigue (score <60) were randomized 1:1 into two intervention groups (A and B). Both groups were asked to track their sleep for 2 weeks using a standardized sleep log. Group B also had in-person sleep hygiene counseling. Outcomes were assessed 2 weeks after intervention implementation through repeat PedsQL-MDFS, self-reported behavior change surveys, and analysis of 2-week sleep logs.

Results: Sixty-six patients were enrolled. The mean age was 16.5 years, 53% male, 71% Crohn's disease, and 25% ulcerative colitis. Forty-three patients met criteria for randomization into the intervention groups. There was a significant improvement in the PedsQL-MDFS Sleep/Rest Fatigue score in both intervention groups. Sleep hygiene counseling for Group B resulted in a significant increase in patients putting their electronic screens away 30 min before bedtime.

Conclusion: Sleep tracking and in-person sleep counseling positively impact sleep/rest fatigue scores and sleep behavior change. These simple interventions hold the promise of improving sleep and fatigue in children and adolescents with IBD.