P0248 Insomnia as a determinant of poor IBD disease course
Bibliographic record
Abstract
Abstract Background Insomnia is one of the most common sleep disorders, affecting up to 30% of the adult population worldwide. Sleep disorders can have a marked impact on immune functions and inflammation, including in patients with inflammatory bowel diseases (IBD) in both active and inactive disease states. Whether insomnia preceding IBD flares affects clinical outcomes is unknown. We examined the association between insomnia and IBD-related outcomes in adults diagnosed with of Crohn’s disease (CD) or ulcerative colitis (UC). Methods A retrospective, real-world, cohort study utilizing the Lynx MD’s electronic medical record dataset, provided by a US-based community gastroenterology practice. Deidentified patient charts were analyzed to identify patients with a confirmed diagnosis of IBD (either CD or UC). Eligibility criteria included: ≥3 diagnoses of IBD, ≥1 diagnoses of IBD and: histopathologic diagnosis of IBD; or IBD related surgery; or ≥ 3 months of treatment with standard accepted therapies for IBD; and ≥3 years of follow-up. IBD-related events of hospitalization and/or surgery were recorded. The cohort was classified into two groups based on insomnia diagnosis, prior to IBD related hospitalizations or surgeries. We implemented Cox Proportional Regression models to estimate Hazard Ratios for the IBD-related outcomes. Results Among 20,011 patients with IBD, 10,775 (54%) were women, at a mean age of 48.2 ± 18.2 years old, 11,842 (59%) were diagnosed with UC and 8,169 (41%) with CD. Over 3,100 patients (16%) were diagnosed with insomnia prior to the first IBD related hospitalization or surgery. In an unadjusted model, insomnia was significantly associated with IBD-related hospitalizations - hazard ratio (HR) of 1.43 (95% CI 1.28, 1.59) and IBD related surgeries - HR of 1.42 (95% CI 1.12, 1.81). After adjustment for age, sex, race, body mass index, anxiety and type of IBD (CD vs. UC), IBD-affected patients with insomnia had a higher HR of hospitalization and surgery: HR of 1.35 (95% CI 1.2,1.51) and 1.29 (95% CI 1.01,1.66), respectively, compared to those without insomnia. Conclusion In a large real-life dataset of patients with IBD, we found higher rates of IBD-related hospitalizations and surgeries among patients with comorbid insomnia, suggesting that insomnia may be associated with a more severe course of IBD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".