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Sleep and Fatigue in IBD: an Unrecognized but Important Extra-intestinal Manifestation

Abstract

Purpose of Review

The bidirectional relationship between sleep disorders and inflammatory bowel disease (IBD) has gained considerable attention in recent years. It has been suggested that poor sleep and fatigue are extra-intestinal manifestations of IBD. This review reports recent studies exploring subjective and objective assessments of sleep in the adult IBD population.

Recent Findings

In ulcerative colitis patients, poor sleep has been independently linked to depression and poorer IBD-related quality of life. Using home polysomnography, IBD patients were shown to have less rapid eye movement sleep and Crohn’s patient had increased lighter sleep. A study utilizing surveys assessing circadian rhythms described circadian misalignment in IBD patients and reported that circadian misalignment in Crohn’s disease was associated with a more aggressive disease phenotype. The use of biologics may improve sleep disturbances in patients with IBD.

Summary

Translational and clinical studies have reported that disturbances in sleep quality are linked to intestinal inflammation and a heighted systemic immune response. IBD patients appear to have disturbed sleep. Poor sleep is also suggested as a marker for subclinical disease activity. Recent studies have suggested circadian misalignment in IBD patients, and future studies are needed to assess these clinical implications.

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Andrew Canakis: Conception, design, generation, collection, assembly, and drafting of the manuscript.

Taha Qazi: Conception, design, and supervision of the study, generation, collection, drafting, critical revision, and approval of the final version of the manuscript.

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Correspondence to Andrew Canakis.

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Canakis, A., Qazi, T. Sleep and Fatigue in IBD: an Unrecognized but Important Extra-intestinal Manifestation. Curr Gastroenterol Rep 22, 8 (2020). https://doi.org/10.1007/s11894-020-0746-x

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Keywords

  • Inflammatory bowel disease
  • Sleep
  • Circadian rhythm
  • Fatigue
  • Quality of life