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Brief Behavioral Therapy and Bupropion for Sleep and Fatigue in Young Adults With Crohn's Disease: An Exploratory Open Trial Study.

Publication ,  Journal Article
Hashash, JG; Knisely, MR; Germain, A; McAuliff, K; Strassburger, M; Vachon, A; Binion, DG; Regueiro, M; Wallace, M; Szigethy, E
Published in: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
January 2022

Sleep disturbances and fatigue are common symptoms amongst patients with Crohn's disease (CD). The aim of this study was to test the feasibility and effects of a pragmatic, stepped-care intervention for the treatment of poor sleep quality and fatigue in adolescents and young adults with CD.This study is a two-phase open trial exploring interventions for sleep and fatigue. After the initial comprehensive assessment which included quantitative measures and an interview to evaluate sleep and physical and mental health, the 12-week intervention consisted of two sequential steps: 1) a brief behavioral therapy for sleep in inflammatory bowel disease (IBD) (BBTS-I; 4 weeks) and 2) adding the psychotropic medication, bupropion sustained release (BUP-SR; 8 weeks), for the subset of subjects continuing to experience fatigue.232 CD patients (median age=24, median sex=female) were approached over 18 months, of whom 112 screened positive on the Pittsburgh Sleep Quality Index (PSQI) and multi-dimensional fatigue inventory (MFI), with 68 CD patients completing the more comprehensive baseline assessment. Of the 68 patients, 52 participated in Phase I of the BBTS-I intervention. Following 4-weeks of the BBTS-I, there were significant improvements in sleep quality (p < .001) and fatigue (p < .001). As part of Phase II, of the 52 patients who met fatigue threshold criteria, 33 patients participated in the BUP-SR+BBTS-I arm while 19 participated in the BBTS-I only intervention group. After 8 weeks of Phase II, both intervention groups saw significant further improvement in sleep, fatigue, anxiety and depressive symptoms, but without significant differences between the two intervention groups.A stepped-care approach shows that we can improve sleep disturbance with BBTS-I in CD patients, but fatigue only partially improves. For a subset of patients who chose to add BUP-SR to their behavioral therapy, fatigue improves further but not to a statistically significant effect compared to behavioral therapy alone.

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Published In

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

DOI

EISSN

1542-7714

ISSN

1542-3565

Publication Date

January 2022

Volume

20

Issue

1

Start / End Page

96 / 104

Related Subject Headings

  • Young Adult
  • Sleep
  • Quality of Life
  • Humans
  • Gastroenterology & Hepatology
  • Female
  • Fatigue
  • Crohn Disease
  • Bupropion
  • Behavior Therapy
 

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Hashash, J. G., Knisely, M. R., Germain, A., McAuliff, K., Strassburger, M., Vachon, A., … Szigethy, E. (2022). Brief Behavioral Therapy and Bupropion for Sleep and Fatigue in Young Adults With Crohn's Disease: An Exploratory Open Trial Study. Clinical Gastroenterology and Hepatology : The Official Clinical Practice Journal of the American Gastroenterological Association, 20(1), 96–104. https://doi.org/10.1016/j.cgh.2020.09.047
Hashash, Jana G., Mitchell R. Knisely, Anne Germain, Katheryn McAuliff, Meredith Strassburger, Ashley Vachon, David G. Binion, Miguel Regueiro, Meredith Wallace, and Eva Szigethy. “Brief Behavioral Therapy and Bupropion for Sleep and Fatigue in Young Adults With Crohn's Disease: An Exploratory Open Trial Study.Clinical Gastroenterology and Hepatology : The Official Clinical Practice Journal of the American Gastroenterological Association 20, no. 1 (January 2022): 96–104. https://doi.org/10.1016/j.cgh.2020.09.047.
Hashash JG, Knisely MR, Germain A, McAuliff K, Strassburger M, Vachon A, et al. Brief Behavioral Therapy and Bupropion for Sleep and Fatigue in Young Adults With Crohn's Disease: An Exploratory Open Trial Study. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2022 Jan;20(1):96–104.
Hashash, Jana G., et al. “Brief Behavioral Therapy and Bupropion for Sleep and Fatigue in Young Adults With Crohn's Disease: An Exploratory Open Trial Study.Clinical Gastroenterology and Hepatology : The Official Clinical Practice Journal of the American Gastroenterological Association, vol. 20, no. 1, Jan. 2022, pp. 96–104. Epmc, doi:10.1016/j.cgh.2020.09.047.
Hashash JG, Knisely MR, Germain A, McAuliff K, Strassburger M, Vachon A, Binion DG, Regueiro M, Wallace M, Szigethy E. Brief Behavioral Therapy and Bupropion for Sleep and Fatigue in Young Adults With Crohn's Disease: An Exploratory Open Trial Study. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2022 Jan;20(1):96–104.
Journal cover image

Published In

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

DOI

EISSN

1542-7714

ISSN

1542-3565

Publication Date

January 2022

Volume

20

Issue

1

Start / End Page

96 / 104

Related Subject Headings

  • Young Adult
  • Sleep
  • Quality of Life
  • Humans
  • Gastroenterology & Hepatology
  • Female
  • Fatigue
  • Crohn Disease
  • Bupropion
  • Behavior Therapy