Wang XR, Zhang N, Li B, Zhang QM, Li MR, Ma HW. Sleep quality, treatment burden, and quality of life in patients with inflammatory bowel disease: A cross-sectional study. World J Gastroenterol 2026; 32(47): 122108 [DOI: 10.3748/wjg.122108]
Corresponding Author of This Article
Hong-Wen Ma, Chief Nurse, Department of Nursing, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, No. 190 Jieyuan Road, Hongqiao District, Tianjin 300121, China. hongwenma1@163.com
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Wang XR, Zhang N, Li B, Zhang QM, Li MR, Ma HW. Sleep quality, treatment burden, and quality of life in patients with inflammatory bowel disease: A cross-sectional study. World J Gastroenterol 2026; 32(47): 122108 [DOI: 10.3748/wjg.122108]
World J Gastroenterol. Dec 21, 2026; 32(47): 122108 Published online Dec 21, 2026. doi: 10.3748/wjg.122108
Sleep quality, treatment burden, and quality of life in patients with inflammatory bowel disease: A cross-sectional study
Xiao-Ran Wang, Nan Zhang, Bei Li, Qiao-Mei Zhang, Mu-Ran Li, Hong-Wen Ma
Xiao-Ran Wang, Nan Zhang, Bei Li, Mu-Ran Li, Department of Gastroenterology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin 300121, China
Qiao-Mei Zhang, Hong-Wen Ma, Department of Nursing, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin 300121, China
Co-first authors: Xiao-Ran Wang and Nan Zhang.
Author contributions: Wang XR and Zhang N conceived the study, collected data, and performed data analysis as co-first authors; Li B and Li MR collected data; Wang XR and Zhang QM prepared the first draft of the manuscript; Li MR and Ma HW analyzed articles; all authors contributed to analyzing articles and revising. All authors read and approved the final manuscript.
AI contribution statement: No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions.
Supported by Tianjin Health Research Project, No. TJWJ2024MS018.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Tianjin Union Medical Center, No. 2023C21.
Informed consent statement: All study participants provided informed written consent (electronically) prior to their enrollment in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author.
Corresponding author: Hong-Wen Ma, Chief Nurse, Department of Nursing, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, No. 190 Jieyuan Road, Hongqiao District, Tianjin 300121, China. hongwenma1@163.com
Received: April 10, 2026 Revised: May 9, 2026 Accepted: June 30, 2026 Published online: December 21, 2026 Processing time: 200 Days and 20.3 Hours
Abstract
BACKGROUND
The management of inflammatory bowel disease (IBD) requires balancing a patient’s treatment workload with his physical and psychological coping capacity. However, the synergistic impact of treatment burden and sleep disturbance on the quality of life (QoL) remains ill-defined in clinical gastroenterology practice.
AIM
To determine the associations of sleep quality and treatment burden with QoL in IBD.
METHODS
This cross-sectional study enrolled 158 patients with IBD at a tertiary hospital in China between December, 2023 and June, 2024. Participants completed the IBD Questionnaire, the Pittsburgh Sleep Quality Index, and the Treatment Burden Questionnaire. Descriptive statistics, Spearman’s correlation, and multiple linear regression analysis were utilized to identify the independent predictors of QoL.
RESULTS
Overall, 34.81% of the participants reported poor QoL, and 61.39% (n = 97) experienced poor sleep quality. The mean treatment burden score was 39.81 ± 30.54. Multiple linear regression analysis revealed that a higher treatment burden (β = -0.287, P < 0.001), poorer sleep quality (β = -0.286, P < 0.001), and a higher number of hospitalizations in the past year (β = -0.162, P = 0.025) were independent predictors of lower QoL. These modifiable clinical variables collectively explained 25.4% of the variance in the overall QoL scores.
CONCLUSION
High treatment burden and poor sleep quality correlate with lower QoL in patients with IBD, suggesting that managing sleep and treatment-related stressors may optimize patient outcomes.
Core Tip: After applying the novel Cumulative Complexity Model, this study showed that a severe imbalance between patient “workload” (escalating treatment burden) and depleted “capacity” (fragmented sleep) are independently associated with the deterioration of quality of life in patients with inflammatory bowel disease. With 61.39% of patients experiencing poor sleep, our findings complement the traditional methods that focus solely on mucosal healing. We thus urge a paradigm shift in inflammatory bowel disease management: Multidisciplinary teams must urgently integrate routine sleep screening and systemic burden-relief strategies, such as streamlining care pathways, to help restore patient resilience and optimize long-term quality of life.
