The quality of sleep in patients with coeliac disease


Dr C. Ciacci, Department of Clinical and Experimental Medicine, Federico II University of Naples, Via Sergio Pansini, 5, Naples 80131, Italy.


Aliment Pharmacol Ther 2010; 32: 1031–1036


Background  Coeliac disease is a chronic disease with a various clinical presentation, including anxiety and depression.

Aim  To investigate the quality of sleep in coeliac disease.

Methods  The participants were coeliacs at diagnosis; coeliacs on a gluten-free diet at follow-up and healthy volunteers. Participants completed the Pittsburgh Sleep Quality Index (PSQI), SF36, Zung and Fatigue scales and State-Trait Anxiety Inventory (STAI).

Results  The PSQI score was higher in coeliacs at diagnosis and in a gluten-free diet than in healthy volunteers (< 0.001). A gluten-free diet did not improve the PSQI score (= 0.245) in coeliac disease. The other test scores were similar between coeliacs at diagnosis and those on a gluten-free diet, whereas significant differences were found between coeliacs and volunteers. PSQI score was inversely associated with the quality of the physical (r = −0.327, = 0.002) and mental (r = −0.455, < 0.001) component scores. The sleep quality scores were related to depression (r = 0.633, < 0.001), fatigue (r = 0.377, < 0.001), state anxiety (r = 0.484, < 0.001) and trait anxiety (r = 0.467, < 0.001).

Conclusions  Sleep disorders are common in coeliac disease not only at diagnosis but also during treatment with a gluten-free diet. Sleep disorders are related to depression, anxiety and fatigue, and inversely related to quality of life scale scores.