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Poor Sleep in Inflammatory Bowel Disease Is Reflective of Distinct Sleep Disorders

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Abstract

Background

Poor sleep is common in inflammatory bowel disease (IBD), predicting increased risk of flares, surgery, and/or hospitalization and reducing quality of life.

Aims

To profile specific sleep disorder symptoms in IBD, informing intervention efforts.

Methods

312 adults with Crohn’s disease or ulcerative colitis were recruited from an academic medical center in New Hampshire, USA. Participants completed online surveys about sleep including well-validated measures of sleep quality, insomnia, restless leg syndrome, sleep apnea, and circadian rhythms. Participants also answered questions about IBD-related problems that could interfere with sleep.

Results

69.4% of participants reported experiencing poor sleep and 50% reported clinically significant insomnia. Participants with active IBD symptoms were more likely to have poor sleep and insomnia. Of those with poor sleep, 67.8% met the clinical threshold for insomnia disorder and 31.3% met criteria for two or more sleep disorders. IBD-related sleep disruptions (e.g., nighttime awakenings due to bowel movements) were not significantly related to poor sleep quality, but significantly related to insomnia severity for participants with active Crohn’s disease.

Conclusions

While poor sleep in IBD is reflective of a number of different sleep problems, it is most frequently related to insomnia. IBD symptom severity contributes to insomnia, but insomnia is also distinct from IBD-related sleep disruptions. Future research on the treatment of insomnia disorder in particular in individuals with IBD is warranted.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Funding

This work was supported by internal funding from the Departments of Psychiatry and Medicine (section of Gastroenterology and Hepatology) at Dartmouth-Hitchcock/Geisel School of Medicine at Dartmouth.

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Authors and Affiliations

  1. Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03784, USA

    Jessica K. Salwen-Deremer & Hannah G. Haskell

  2. Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    Jessica K. Salwen-Deremer & Corey A. Siegel

  3. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Michael T. Smith & Colleen Schreyer

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  1. Jessica K. Salwen-Deremer
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  2. Michael T. Smith
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Contributions

JSD designed the study with critical input from MTS and CAS, JSD, HGH, and CAS collected the data and JSD and CS analyzed the data. JSD developed the initial draft of the paper, and all authors critically revised the manuscript for important intellectual content. All authors approved the final version of this manuscript, including the authorship list. JSD is the Guarantor of the article.

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Correspondence to Jessica K. Salwen-Deremer.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Dartmouth-Hitchcock Institutional Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Individuals in this study agreed to a consent document prior to their participation.

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Salwen-Deremer, J.K., Smith, M.T., Haskell, H.G. et al. Poor Sleep in Inflammatory Bowel Disease Is Reflective of Distinct Sleep Disorders. Dig Dis Sci 67, 3096–3107 (2022). https://doi.org/10.1007/s10620-021-07176-y

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  • DOI: https://doi.org/10.1007/s10620-021-07176-y

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