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Tian M, Song Y, Guo Y, Jiang T. Association between sleep disorders and constipation Risk: A systematic review and Meta-Analysis. J Clin Neurosci 2024; 126:12-20. [PMID: 38821029 DOI: 10.1016/j.jocn.2024.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES The objective of this study was to evaluate the potential relationship between sleep disturbances and various types of constipation in patients. METHODS We conducted systematic searches in the research databases PubMed, EMBASE, Web of Science, and Cochrane Library to identify qualifying studies. Using Stata software version 14.0, we calculated the Odds Ratio (OR) and 95 % confidence interval (CI) for constipation in patients with sleep disorders. If P > 0.1 and I2 ≤ 50 %, we employed a fixed-effects model; otherwise, we applied a random-effects model. We assessed publication bias using funnel plots and Egger's test. RESULT The pooled analysis demonstrated that individuals with sleep disorders were associated with an increased risk of all-cause constipation (OR = 1.47; 95 %CI: 1.31-1.64; I2 = 88.8 %, P<0.001). Specifically, both children (OR = 1.29; 95 %CI: 1.16-1.42; I2 = 63.8 %, P<0.001) and adults (OR = 1.65; 95 %CI: 1.39-1.97; I2 = 92.4 %, P<0.001) with a history of sleep disorders exhibited an increased risk of all-cause constipation.. Furthermore, patients with a history of insufficient sleep were also associated with an increased risk of constipation (OR = 1.33; 95 %CI: 1.20-1.46; I2 = 6.7 %, P<0.001). Additionally, patients with poor sleep quality were found to have an increased risk of constipation (OR = 1.56; 95 %CI: 1.0-2.45; I2 = 90.9 %, P = 0.05). Lastly, patients with insomnia were found to have the highest risk of constipation (OR = 1.94; 95 %CI: 1.37-2.76; I2 = 97.8 %, P<0.001). CONCLUSION This meta-analysis indicates that sleep disorders are associated with an elevated risk of constipation. Insomnia, poor sleep quality, and insufficient sleep duration all contribute to elevating the risk of constipation. These findings emphasize the significance of recognizing sleep disorders as an independent risk factor for constipation in both children and adults.
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Affiliation(s)
- Minhui Tian
- School of Clinical Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Yongfu Song
- Department of Pediatrics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yan Guo
- School of Clinical Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Tongwei Jiang
- School of Clinical Medicine, Changchun University of Chinese Medicine, Changchun, China.
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Wang J, Sui WN, Zhao YQ, Meng SY, Han WX, Ni J. Genetic evidence for the causal impact of insomnia on gastrointestinal diseases and the mediating effects of adiposity traits. J Gastroenterol Hepatol 2024. [PMID: 38981855 DOI: 10.1111/jgh.16678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/12/2024] [Accepted: 06/24/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND AND AIM Insomnia has been implicated in gastrointestinal diseases (GIs), but the causal effect between insomnia and GIs and underlying mechanisms remain unknown. METHODS By using the released summary-level data, we conducted a two-step Mendelian randomization (MR) analysis to examine the relationship between insomnia and four GIs and estimate the mediating role of candidate mediators. The first step was to investigate the causal association between insomnia and GIs using univariable MR analysis. The second step was to estimate the mediation proportion of selected mediators in these associations using multivariable MR analysis. Subsequently, results from different datasets were combined using the fixed-effect meta-analysis. RESULTS Univariable MR analysis provided strong evidence for the causal effects of insomnia on four GIs after Bonferroni correction for multiple comparisons, including peptic ulcer disease (PUD) (odds ratio [OR] = 1.15, 95% interval confidence [CI] = 1.10-1.20, P = 1.83 × 10-9), gastroesophageal reflux (GORD) (OR = 1.19, 95% CI = 1.16-1.22, P = 5.95 × 10-42), irritable bowel syndrome (IBS) (OR = 1.18, 95% CI = 1.15-1.22, P = 8.69 × 10-25), and inflammatory bowel disease (IBD) (OR = 1.09, 95% CI = 1.03-1.05, P = 3.46 × 10-3). In the mediation analysis, body mass index (BMI) and waist-to-hip ratio (WHR) were selected as mediators in the association between insomnia and PUD (BMI: mediation proportion [95% CI]: 13.61% [7.64%-20.70%]; WHR: 8.74% [5.50%-12.44%]) and GORD (BMI: 11.82% [5.94%-18.74%]; WHR: 7.68% [4.73%-11.12%]). CONCLUSIONS Our findings suggest that genetically instrumented insomnia has causal effects on PUD, GORD, IBS, and IBD, respectively. Adiposity traits partially mediated the associations between insomnia and GIs. Further clinical studies are warranted to evaluate the protective effect of insomnia treatment on GIs.
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Affiliation(s)
- Jing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Wan-Nian Sui
- Department of Gastrointestinal Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yu-Qiang Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Shi-Yin Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Wen-Xiu Han
- Department of Gastrointestinal Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jing Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, Hefei, China
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Liu M, Ye Z, Wu Q, Yang S, Zhang Y, Zhou C, He P, Zhang Y, Qin X. Healthy sleep, mental health, genetic susceptibility, and risk of irritable bowel syndrome. J Affect Disord 2023; 331:25-32. [PMID: 36934852 DOI: 10.1016/j.jad.2023.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND We aimed to investigate the prospective association of individual and combined sleep behaviors and mental health (psychological distress and neuroticism) with incident irritable bowel syndrome (IBS). METHODS A total of 302,839 participants without prior IBS in the UK Biobank were enrolled. A healthy sleep score was created according to five sleep factors and defined the low-risk groups as follows: sleep 7-8 h/day, early chronotype, never/rarely insomnia, no snoring, and no frequent excessive daytime sleepiness. Psychological distress and neuroticism were ascertained using the Patient Health Questionnaire and the Eysenck Personality Questionnaire-Revised Short Form, respectively. The primary outcome was incident IBS, based on self-report or linkage to death register and/or primary care and/or hospital admission data. RESULTS During a median follow-up of 12.0 years, 5574 participants developed IBS. Overall, low-risk sleep behaviors and a healthy sleep score (per one point increment, HR, 0.81, 95%CI, 0.79-0.83) were associated with a lower risk of incident IBS, 29.4 %-32.4 % of which was mediated by mental health. Psychological distress (per one point increment, HR, 1.16, 95%CI, 1.14-1.17) and neuroticism (HR, 1.11, 95%CI, 1.10-1.12) were positively associated with incident IBS, and healthy sleep scores mediated 8.3 %-9.7 % of the association. Moreover, participants with lowest healthy sleep score/highest mental health score and higher genetic risk of IBS showed the highest risk of incident IBS. LIMITATIONS Sleep behaviors and mental health were assessed by self-reported questionnaires. CONCLUSIONS Healthy sleep scores and low psychological distress/neuroticism were associated with a lower risk of IBS, regardless of genetic predisposition.
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Affiliation(s)
- Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
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Knapik JJ, Caldwell JA, Steelman RA, Trone DW, Farina EK, Lieberman HR. Short sleep duration is associated with a wide variety of medical conditions among United States military service members. Sleep Med 2023; 101:283-295. [PMID: 36470164 DOI: 10.1016/j.sleep.2022.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This cross-sectional study investigated self-reported sleep duration and its association with a comprehensive range of clinically-diagnosed medical condition categories (CDMCs), as well as the relationship between short sleep duration (≤6 h) and demographic/lifestyle factors, among United States military service members (SMs). METHODS A stratified random sample of SMs (n = 20,819) completed an online questionnaire on usual daily hours of sleep and demographic/lifestyle characteristics. CDMCs for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 33 CDMCs covering both broad and specific medical conditions. Prevalence of CDMCs was compared among three sleep duration categories (≤4, 5-6 and ≥7 h). RESULTS SMs reported a mean ± standard deviation of 6.3 ± 1.4 h of sleep per day. After adjustment for demographic/lifestyle characteristics, shorter sleep duration was associated with higher odds of a medical condition in 25 of 33 CDMCs, with most (n = 20) demonstrating a dose-response relationship. The five CDMCs with the largest differences between ≤4 vs ≥ 7 h sleep were: diseases of the nervous system (odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 2.4-3.4), mental/behavioral diseases (OR = 2.7, 95%CI = 2.3-3.2), diseases of the musculoskeletal system (OR = 1.9, 95%CI = 1.6-2.1), diseases of the circulatory system (OR = 1.7, 95%CI = 1.3-2.2), and diseases of the digestive system (OR = 1.6, 95%CI = 1.2-2.0). Six hours of sleep or less was independently associated with older age, less formal education, race, Hispanic ethnicity, higher body mass index, smoking, and military service branch. CONCLUSIONS In this young, physically active population, reporting shorter sleep duration was associated with a higher risk of multiple CDMCs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - John A Caldwell
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA; Laulima Government Solutions, 5301 Buckystown Pike, STE 460, Frederick, MD, 21704, USA
| | - Ryan A Steelman
- U.S. Army Public Health Center, 8252 Blackhawk Rd, Aberdeen Proving Ground, MD, 21010, USA
| | - Daniel W Trone
- Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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Yang S, Li SZ, Guo FZ, Zhou DX, Sun XF, Tai JD. Association of sleep duration with chronic constipation among adult men and women: Findings from the National Health and Nutrition Examination Survey (2005-2010). Front Neurol 2022; 13:903273. [PMID: 36034289 PMCID: PMC9399653 DOI: 10.3389/fneur.2022.903273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous studies suggested that unhealthy sleep patterns were closely associated with gastrointestinal diseases, but the impact of unhealthy sleep duration on chronic constipation has not been well studied until now. In this study, we aim to explore the association between sleep duration and constipation among males and females. Methods We utilized the US National Health and Nutrition Examination Surveys data from 2005 to 2010, and adults (≥20 years old) who completed the sleep and bowel health questionnaires were enrolled in this observational study. Sleep duration was categorized into four groups: very short sleep (<5 h/night), short sleep (5-6 h/night), normal sleep (7-8 h/night), and long sleep (≥9 h/night). Chronic constipation was defined as Bristol Stool Scale Type 1(separate hard lumps, like nuts) or Type 2(sausage-like but lumpy). Controlling demographic, lifestyle, and dietary factors, the logistic regression model in Generalized Linear Model (GLM) function was used to estimate the correlation of sleep duration with constipation among men and women. Results Of the 11,785 individuals (51.2% males and 48.8% females), 4.3% of men and 10.2% of women had constipation, respectively. More than half of patients with constipation did not adopt the recommended sleep duration. Compared with normal individuals, male participants with constipation had a higher proportion of shorter sleep duration (41.0 vs. 32.3% in the short sleep group and 6.3 vs. 4.7% in the very short sleep group), and female individuals with constipation had a higher proportion of long sleep duration (12.7 vs. 8.2%). After covariates adjustment, men with short sleep duration (5-6 h/night) correlated with increased odds for constipation (OR:1.54, 95%CI:1.05-2.25), and women with long sleep duration (≥9 h/night) linked to the higher constipation risk (OR:1.58, 95%CI:1.10-2.29). Excessive sleep duration in males or insufficient sleep duration in females was neither linked to increased nor decreased constipation risk. Conclusions In this observational study of a nationally representative sample of adults, we demonstrate a differential impact of unhealthy sleep duration on constipation among men and women. Short sleep duration poses a higher risk of constipation in men, and excessive sleep duration correlates with higher constipation risk in women.
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Affiliation(s)
- Shuai Yang
- Department of Ultrasound, The First Hospital of Jilin University, Changchun, China
| | - Shou-Zhen Li
- Department of Ultrasound, The First Hospital of Jilin University, Changchun, China
| | - Fu-Zheng Guo
- Department of Ultrasound, The First Hospital of Jilin University, Changchun, China
| | - Dong-Xu Zhou
- Department of Ultrasound, The First Hospital of Jilin University, Changchun, China
| | - Xiao-Feng Sun
- Department of Ultrasound, The First Hospital of Jilin University, Changchun, China
| | - Jian-Dong Tai
- Department of Colorectal and Anal Surgery, The First Hospital of Jilin University, Changchun, China
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Rowley JA, Badr MS. Normal Sleep. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Saidi O, Rochette E, Del Sordo G, Doré É, Merlin É, Walrand S, Duché P. Eucaloric Balanced Diet Improved Objective Sleep in Adolescents with Obesity. Nutrients 2021; 13:nu13103550. [PMID: 34684551 PMCID: PMC8537106 DOI: 10.3390/nu13103550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/20/2022] Open
Abstract
Background: A better understanding of the influence of energy balance on sleep in adolescents, particularly those with obesity, could help develop strategies to optimize sleep in these populations. The purpose of this study was to investigate sleep under ad libitum-vs-controlled diets adjusted to energy requirement (eucaloric) among adolescents with obesity and their normal weight controls. Methods: Twenty-eight male adolescents aged between 12 and 15 years, n = 14 adolescents with obesity (OB: BMI ≥ 90th centile) and n = 14 normal weight age matched controls (NW), completed an experimental protocol comprising ad libitum or eucaloric meals for three days, in random order. During the third night of each condition, they underwent in home polysomnography (PSG). Results: An interaction effect of energy intake (EI) was detected (p < 0.001). EI was higher during ad libitum compared to the eucaloric condition (p < 0.001) and in OB compared to NW (p < 0.001) in the absence of any substantial modification to macronutrient proportions. Analyses of energy intake distribution throughout the day showed a significant interaction with both a condition and group effect during lunch and dinner. Sleep improvements were noted in OB group during the eucaloric condition compared to ad libitum with reduced sleep onset latency and N1 stage. Sleep improvements were correlated to reduced EI, especially during the evening meal. Conclusion: Simply adjusting dietary intake to energy requirement and reducing the energy proportion of the evening meal could have therapeutic effects on sleep in adolescents with obesity. However, positive energy balance alone cannot justify worsened sleep among adolescents with obesity compared to normal weight counterparts.
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Affiliation(s)
- Oussama Saidi
- Laboratory Impact of Physical Activity on Health (IAPS), Toulon University, F-83000 Toulon, France; (O.S.); (E.R.); (G.D.S.)
- Laboratory of Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, F-63170 Clermont-Ferrand, France;
- Regional Center for Human Nutrition (CRNH Auvergne), F-63000 Clermont-Ferrand, France
| | - Emmanuelle Rochette
- Laboratory Impact of Physical Activity on Health (IAPS), Toulon University, F-83000 Toulon, France; (O.S.); (E.R.); (G.D.S.)
- Department of Pediatrics, Clermont-Ferrand University Hospital, F-63000 Clermont-Ferrand, France;
- INSERM, CIC 1405, CRECHE Unit, CHU Clermont-Ferrand, Clermont Auvergne University, F-63000 Clermont-Ferrand, France
| | - Giovanna Del Sordo
- Laboratory Impact of Physical Activity on Health (IAPS), Toulon University, F-83000 Toulon, France; (O.S.); (E.R.); (G.D.S.)
| | - Éric Doré
- Laboratory of Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, F-63170 Clermont-Ferrand, France;
- Regional Center for Human Nutrition (CRNH Auvergne), F-63000 Clermont-Ferrand, France
| | - Étienne Merlin
- Department of Pediatrics, Clermont-Ferrand University Hospital, F-63000 Clermont-Ferrand, France;
- INSERM, CIC 1405, CRECHE Unit, CHU Clermont-Ferrand, Clermont Auvergne University, F-63000 Clermont-Ferrand, France
| | - Stéphane Walrand
- INRAE, UNH, CHU Clermont-Ferrand, Clermont Auvergne University, F-63000 Clermont-Ferrand, France;
| | - Pascale Duché
- Laboratory Impact of Physical Activity on Health (IAPS), Toulon University, F-83000 Toulon, France; (O.S.); (E.R.); (G.D.S.)
- Correspondence: ; Tel.: +33-(0)-652-1838-91
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Koloski NA, Jones M, Walker MM, Keely S, Holtmann G, Talley NJ. Sleep disturbances in the irritable bowel syndrome and functional dyspepsia are independent of psychological distress: a population-based study of 1322 Australians. Aliment Pharmacol Ther 2021; 54:627-636. [PMID: 34247414 DOI: 10.1111/apt.16500] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/18/2021] [Accepted: 06/09/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Psychological distress, strongly associated with functional gastrointestinal disorders (FGIDS), likely plays a central role in the pathophysiology. The role of sleep disturbances in FGIDs is unclear, and an association with psychological factors is uncertain. AIM To determine whether sleep disturbances are associated with irritable bowel syndrome (IBS) and functional dyspepsia (FD) and if a potential association is explained by psychological distress. METHODS Adult sample randomly selected from a region in New South Wales, Australia in 2015 who returned a follow-up mail survey in 2018 (response rate, 60.5%) that contained questions on IBS, FD, sleep (MOS-Sleep Scale) and psychological distress (Kessler 6 scale). RESULTS Among this population, 10.4% (95% CI 8.8-12.2) and 17.9% (95% CI 15.9-20.1) met Rome III criteria for IBS and FD, respectively. The prevalence of any sleep disturbance at least most of the time was common, with a significantly higher prevalence in FGID (IBS and/or FD) compared with the remaining population (41.8% vs 32.2%, P = 0.003). The total sleep problem index was significantly higher for IBS (OR = 1.71 [95% CI 1.29-2.27], P < 0.0001) (IBS-diarrhoea predominant and IBS-mixed but not IBS-constipation) and FD (OR = 1.80 [1.43-2.26], P < 0.0001) (both epigastric pain syndrome and postprandial distress syndrome) even after adjusting for age, sex and psychological distress. CONCLUSION Both IBS and FD, and most of their major subtypes except IBS-C, are associated with a range of sleep disturbances. These sleep problems do not appear to be explained by psychological factors and may play an independent role in the pathophysiology.
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Affiliation(s)
- Natasha A Koloski
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Faculty of Health and Behavioural Sciences, University of Queensland, Herston, QLD, Australia
| | - Michael Jones
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Marjorie M Walker
- School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Simon Keely
- School of Biomedical Sciences and Pharmacy, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Gerald Holtmann
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Faculty of Medicine, University of Queensland, St. Lucia, QLD, Australia
| | - Nicholas J Talley
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
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Vernia F, Di Ruscio M, Ciccone A, Viscido A, Frieri G, Stefanelli G, Latella G. Sleep disorders related to nutrition and digestive diseases: a neglected clinical condition. Int J Med Sci 2021; 18:593-603. [PMID: 33437194 PMCID: PMC7797530 DOI: 10.7150/ijms.45512] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/04/2020] [Indexed: 02/06/2023] Open
Abstract
Sleep disturbances often result from inappropriate lifestyles, incorrect dietary habits, and/or digestive diseases. This clinical condition, however, has not been sufficiently explored in this area. Several studies have linked the circadian timing system to the physiology of metabolism control mechanisms, energy balance regulation, and nutrition. Sleep disturbances supposedly trigger digestive disorders or conversely represent specific clinical manifestation of gastrointestinal (GI) diseases. Poor sleep may worsen the symptoms of GI disorders, affecting the quality of life. Conversely, short sleep may influence dietary choices, as well as meal timing, and the circadian system drives temporal changes in metabolic patterns. Emerging evidence suggests that patients with inappropriate dietary habits and chronic digestive disorders often sleep less and show lower sleep efficiency, compared with healthy individuals. Sleep disturbances may thus represent a primary symptom of digestive diseases. Further controlled trials are needed to fully understand the relationship between sleep disturbances, dietary habits, and GI disorders. It may be also anticipated that the evaluation of sleep quality may prove useful to drive positive interventions and improve the quality of life in a proportion of patients. This review summarizes data linking sleep disorders with diet and a series of disease including gastro-esophageal reflux disease, peptic disease, functional gastrointestinal disorders, inflammatory bowel diseases, gut microbiota alterations, liver and pancreatic diseases, and obesity. The evidence supporting the complex interplay between sleep dysfunction, nutrition, and digestive diseases is discussed.
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Affiliation(s)
- Filippo Vernia
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L'Aquila, Piazza S. Tommasi, 1- Coppito, 67100 L'Aquila, Italy
| | - Mirko Di Ruscio
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L'Aquila, Piazza S. Tommasi, 1- Coppito, 67100 L'Aquila, Italy
| | - Antonio Ciccone
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L'Aquila, Piazza S. Tommasi, 1- Coppito, 67100 L'Aquila, Italy
| | - Angelo Viscido
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L'Aquila, Piazza S. Tommasi, 1- Coppito, 67100 L'Aquila, Italy
| | - Giuseppe Frieri
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L'Aquila, Piazza S. Tommasi, 1- Coppito, 67100 L'Aquila, Italy
| | - Gianpiero Stefanelli
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L'Aquila, Piazza S. Tommasi, 1- Coppito, 67100 L'Aquila, Italy
| | - Giovanni Latella
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L'Aquila, Piazza S. Tommasi, 1- Coppito, 67100 L'Aquila, Italy
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10
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Bazin T, Micoulaud Franchi JA, Terras N, Taillard J, Laharie D, Zerbib F, Philip P. Altered sleep quality is associated with Crohn’s disease activity: an actimetry study. Sleep Breath 2019; 24:971-977. [DOI: 10.1007/s11325-019-01934-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/20/2019] [Accepted: 08/29/2019] [Indexed: 12/22/2022]
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11
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Chakradeo PS, Keshavarzian A, Singh S, Dera AE, Esteban JPG, Lee AA, Burgess HJ, Fogg L, Swanson GR. Chronotype, social jet lag, sleep debt and food timing in inflammatory bowel disease. Sleep Med 2018; 52:188-195. [PMID: 30243610 DOI: 10.1016/j.sleep.2018.08.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 12/29/2022]
Abstract
The preference of the sleep/wake cycle can be grouped into categories or chronotypes. Inflammatory bowel disease (IBD) has been linked to poor sleep quality which correlates with disease severity. Social jet lag (SJL) is the difference between sleep timing on work and free days and is a marker for circadian misalignment which has been linked to increased inflammation. We investigated whether chronotype, SJL, sleep debt (SD), and food timing were associated with an IBD specific complications and a lower quality of life. Overall, 191 subjects (115 IBD subjects and 76 healthy controls (HC)) completed the Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), Munich ChronoType Questionnaire (MCTQ), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and a structured Food Timing Questionnaire. Later chronotype (by MEQ) was associated with a worse SIBDQ (r = -0.209; P < 0.05). SJL was increased in IBD at 1.32 h ± 1.03 vs. 1.05 h ± 0.97 in HC, P < 0.05, when adjusted for age. SJL (>2 h) was present in 40% of severe/complicated Crohn's patients (fistulizing or structuring Crohn's or history of Crohn's related surgery) compared to only 16% of uncomplicated Crohn's patients (P < 0.05). Sleep debt was increased in IBD subjects compared to HC at 21.90 m ± 25.37 vs. 11.49 m ± 13.58, P < 0.05. IBD subjects with inconsistent breakfast or dinner times had lower SIBDQ scores (4.78 ± 1.28 vs. 5.49 ± 1.02, P < 0.05; 4.95 ± 0.31 vs. 5.42 ± 0.32, P < 0.05 respectively). In summary, later chronotype, and markers of circadian misalignment (social jet lag, sleep debt, and inconsistent meal timing) were associated with IBD disease specific complications and/or lower quality of life.
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Affiliation(s)
- Prachi S Chakradeo
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
| | - Ali Keshavarzian
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
| | - Shubha Singh
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
| | - Akram E Dera
- Internal Medicine, Greater Baltimore Medical Center, Towson, MD, United States.
| | | | - Alice A Lee
- Rush University Medical Center, Chicago, IL, 60612, United States.
| | - Helen J Burgess
- Biological Rhythms Research Laboratory, Rush University Medical Center, Chicago, IL, 60612, United States.
| | - Louis Fogg
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
| | - Garth R Swanson
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Rush University Medical Center, 1725 W. Harrison, Suite 206, Chicago, IL, 60612, United States.
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12
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Pigarev IN, Pigareva ML. Association of sleep impairments and gastrointestinal disorders in the context of the visceral theory of sleep. J Integr Neurosci 2018; 16:143-156. [PMID: 28891506 DOI: 10.3233/jin-170005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
It was noticed long ago that sleep disorders or interruptions to the normal sleep pattern were associated with various gastrointestinal disorders. We review the studies which established the causal link between these disorders and sleep impairment. However, the mechanism of interactions between the quality of sleep and gastrointestinal pathophysiology remained unclear. Recently, the visceral theory of sleep was formulated. This theory proposes that the same brain structures, and particularly the same cortical sensory areas, which in wakefulness are involved in processing of the exteroceptive information, switch during sleep to the processing of information coming from various visceral systems. We review the studies which demonstrated that neurons of the various cortical areas (occipital, parietal, frontal) during sleep began to fire in response to activation coming from the stomach and small intestine. These data demonstrate that, during sleep, the computational power of the central nervous system, including all cortical areas, is engaged in restoration of visceral systems. Thus, the general mechanism of the interaction between quality of sleep and health became clear.
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Affiliation(s)
- Ivan N Pigarev
- Institute for Information Transmission Problems (Kharkevich Institute), Russian Academy of Sciences, Bol'shoy Karetniy st. 19, Moscow, 127994, Russia. E-mail:
| | - Marina L Pigareva
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Butlerova st. 5-a, Moscow, 117485, Russia. E-mail:
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Johnson DA, Le Moigne A, Li J, Pollack C, Nagy P. Analysis of Clinical Predictors of Resolution of Sleep Disturbance Related to Frequent Nighttime Heartburn and Acid Regurgitation Symptoms in Individuals Taking Esomeprazole 20 mg or Placebo. Clin Drug Investig 2016; 36:531-8. [PMID: 27074935 PMCID: PMC4917592 DOI: 10.1007/s40261-016-0398-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background and Objective Sleep disturbances related to reflux symptoms have a significant impact on the daily lives of affected individuals. These analyses identified clinical factors related to resolution of reflux-related sleep disturbance in subjects treated with esomeprazole 20 mg for 14 days. Methods Data from the first 14 days of 2 similar randomized, double-blind studies were pooled for subjects experiencing frequent heartburn and related sleep disturbances receiving esomeprazole 20 mg (n = 357) or placebo (n = 346). A stepwise logistic regression analysis was performed with pooled and individual study data to evaluate relationships between clinical factors [treatment (esomeprazole vs. placebo), run-in sleep disturbance frequency, occurrence (yes/no) of 24‐h, daytime, and nighttime heartburn (yes: ≥1 episode in 14-day treatment period)] and complete sleep disturbance resolution (no disturbances for 7 consecutive days). Results Absence of daytime (p = 0.0018) or nighttime (p < 0.0001) heartburn during treatment was a significant predictor of complete sleep disturbance resolution at 14 days for the total population, while higher run-in sleep disturbance frequency (p < 0.0001) was associated with a lower likelihood of resolution. Esomeprazole treatment was an independent significant predictor of improvement across all endpoints (p < 0.0001). A significant treatment by run-in sleep disturbance interaction was observed for complete resolution (p = 0.0231), indicating greater therapeutic benefit with esomeprazole in subgroups with higher run-in symptom frequency. Conclusions Lower run-in sleep disturbance frequency, no occurrence of daytime or nighttime heartburn during therapy, and esomeprazole treatment predicted complete reflux-related sleep disturbance resolution. The magnitude of therapeutic benefit for esomeprazole 20 mg over placebo increased with increasing baseline sleep disturbance.
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Affiliation(s)
- David A Johnson
- Eastern Virginia Medical School, 885 Kempsville Road, Suite 114, Norfolk, VA, 23502, USA.
| | | | - Jing Li
- Pfizer Consumer Healthcare, Madison, NJ, USA
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van Langenberg DR, Papandony MC, Gibson PR. Sleep and physical activity measured by accelerometry in Crohn's disease. Aliment Pharmacol Ther 2015; 41:991-1004. [PMID: 25783784 DOI: 10.1111/apt.13160] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 12/30/2014] [Accepted: 02/22/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Sleep and physical activity are inherent to human living, yet appear affected by Crohn's disease (CD), resulting in fatigue and disability. AIM To objectively assess sleep quality and physical activity and their associations using accelerometers, comparing CD vs. matched healthy control (HC) subjects. METHODS Exactly 49 CD and 30 HC subjects completed surveys encompassing self-reported fatigue and sleep quality, pathology testing and wore an accelerometer for 7 days, measuring physical activity and sleep. In this cross-sectional observational study, per-group comparisons were performed and in CD, factors associated with reduced activity and/or sleep quality were assessed via multivariate analyses. RESULTS Regarding physical activity, CD subjects overall performed less total accelerometer counts (median 1.3 × 10(6) vs. 2.0 × 10(6) ), were more sedentary (97.7% vs. 96.2%) and completed fewer bouts of moderate-vigorous intensity exercise (1.0 vs. 5.0, each P < 0.01 (Mann-Whitney) than HC over 7 days. Factors associated with poor physical activity in CD included elevated serum CRP (OR = 22.6), lower vitamin D3 (OR = 13.1) and longer disease duration (OR = 1.2 per year, each P < 0.05). Regarding sleep, the CD group had similar total sleep time (median 458 vs. 447 min, P = 0.56), but more awakenings post-sleep onset (22 vs. 11, P = 0.01). Factors associated with severe sleep dysfunction in CD included lower haemoglobin (OR = 6.7) concurrent anti-TNF (OR = 6.5, each P < 0.05) and opioid therapy (OR = 6.6, P = 0.09). CONCLUSION Utilising objective measurement in a habitual context over 7 days, patients with Crohn's disease exhibited poorer sleep quality and less physical activity than well-matched healthy controls.
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Affiliation(s)
- D R van Langenberg
- Department of Gastroenterology and Hepatology, Eastern Health Clinical School, Monash University, Box Hill, Vic., Australia
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Johnson DA, Le Moigne A, Hugo V, Nagy P. Rapid resolution of sleep disturbances related to frequent reflux: effect of esomeprazole 20 mg in two randomized, double-blind, controlled trials. Curr Med Res Opin 2015; 31:243-50. [PMID: 25478944 DOI: 10.1185/03007995.2014.991818] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the resolution of heartburn and gastroesophageal reflux disease (GERD)-related sleep disturbances during the first 14 days of treatment with esomeprazole 20 mg compared to placebo in subjects with frequent nighttime heartburn and GERD-related sleep disturbances. RESEARCH DESIGN AND METHODS This was a post hoc analysis of 2 week data from two previously published, similarly designed randomized, placebo-controlled trials of 4 weeks' duration comparing esomeprazole 20 mg, 40 mg (one study), and placebo. Inclusion and exclusion criteria for both trials were the same. CLINICAL TRIAL REGISTRATION NCT00628342; NCT00660660. MAIN OUTCOME MEASURES The main outcome measures for this analysis were the resolution and/or relief of GERD-related sleep disturbances during 2 weeks of treatment with esomeprazole 20 mg or placebo. Resolution and/or relief of heartburn symptoms were also measured. RESULTS In trial 1, 455 subjects were randomized, with 225 and 229 receiving esomeprazole 20 mg and placebo, respectively. In trial 2, 276 subjects were randomized, with 142 and 132 receiving esomeprazole and placebo, respectively. After 2 weeks, significantly more subjects who received esomeprazole 20 mg (50.5% [95% confidence interval: 43.8%-57.1%] and 39.4% [31.2%-47.6%] in trials 1 and 2, respectively) had resolution of sleep disturbances compared to placebo (19.9% [14.6%-25.2%] and 16.0% [9.6%-22.4%], respectively; p < 0.0001 for both trials). The median time to resolution of sleep disturbances with esomeprazole 20 mg was 1 day in both trials. After 2 weeks, significantly more subjects receiving esomeprazole 20 mg (32.3% [26.1%-38.5%] and 26.3% [18.9%-33.6%] in trials 1 and 2, respectively) had resolution of nighttime heartburn symptoms compared to placebo (5.4% [2.4%-8.4%] and 4.8% [1.1%-8.5%], respectively; p < 0.0001 for both trials). CONCLUSIONS Esomeprazole 20 mg significantly and effectively reduced nighttime heartburn and GERD-related sleep disturbances in the first 2 weeks of treatment compared to placebo, with rapid resolution of sleep disturbances in the first days of treatment.
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Malloy JN, Paulose JK, Li Y, Cassone VM. Circadian rhythms of gastrointestinal function are regulated by both central and peripheral oscillators. Am J Physiol Gastrointest Liver Physiol 2012; 303:G461-73. [PMID: 22723262 PMCID: PMC3423141 DOI: 10.1152/ajpgi.00369.2011] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Circadian clocks are responsible for daily rhythms in a wide array of processes, including gastrointestinal (GI) function. These are vital for normal digestive rhythms and overall health. Previous studies demonstrated circadian clocks within the cells of GI tissue. The present study examines the roles played by the suprachiasmatic nuclei (SCN), master circadian pacemaker for overt circadian rhythms, and the sympathetic nervous system in regulation of circadian GI rhythms in the mouse Mus musculus. Surgical ablation of the SCN abolishes circadian locomotor, feeding, and stool output rhythms when animals are presented with food ad libitum, while restricted feeding reestablishes these rhythms temporarily. In intact mice, chemical sympathectomy with 6-hydroxydopamine has no effect on feeding and locomotor rhythmicity in light-dark cycles or constant darkness but attenuates stool weight and stool number rhythms. Again, however, restricted feeding reestablishes rhythms in locomotor activity, feeding, and stool output rhythms. Ex vivo, intestinal tissue from PER2::LUC transgenic mice expresses circadian rhythms of luciferase bioluminescence. Chemical sympathectomy has little effect on these rhythms, but timed administration of the β-adrenergic agonist isoproterenol causes a phase-dependent shift in PERIOD2 expression rhythms. Collectively, the data suggest that the SCN are required to maintain feeding, locomotor, and stool output rhythms during ad libitum conditions, acting at least in part through daily activation of sympathetic activity. Even so, this input is not necessary for entrainment to timed feeding, which may be the province of oscillators within the intestines themselves or other components of the GI system.
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Affiliation(s)
- Jaclyn N. Malloy
- 1Department of Biology, University of Kentucky, Lexington, Kentucky; and
| | - Jiffin K. Paulose
- 2Center for Research on Biological Clocks, Texas A & M University, College Station, Texas
| | - Ye Li
- 1Department of Biology, University of Kentucky, Lexington, Kentucky; and
| | - Vincent M. Cassone
- 1Department of Biology, University of Kentucky, Lexington, Kentucky; and
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Heitkemper MM, Cain KC, Deechakawan W, Poppe A, Jun SE, Burr RL, Jarrett ME. Anticipation of public speaking and sleep and the hypothalamic-pituitary-adrenal axis in women with irritable bowel syndrome. Neurogastroenterol Motil 2012; 24:626-31, e270-1. [PMID: 22471712 PMCID: PMC3732110 DOI: 10.1111/j.1365-2982.2012.01915.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Evidence suggests that subgroups of patients with irritable bowel syndrome (IBS) are hyper-responsive to a variety of laboratory stress conditions. METHODS This study compared sleep quality and night time plasma adrenocorticotropic hormone (ACTH) and serum cortisol levels in response to anticipation of public speaking between 43 women with IBS and 24 healthy control women. In addition, comparisons were made between subgroups within the IBS sample based on predominant stool patterns, 22 IBS-constipation and 21 IBS-diarrhea. Subjects slept three nights in a sleep laboratory, and on the third night serial blood samples were drawn every 20 min from 08:00 PM until awakening. As the subjects had different sleep onsets, each subject's results were synchronized to the first onset of stage 2 sleep. KEY RESULTS Compared the healthy control group, women with IBS had significantly worse sleep efficiency, and higher cortisol but not ACTH levels over the night. However, there were no IBS bowel pattern subgroup differences. Among IBS subjects, cortisol levels early in the night were higher than found in our previous study with a similar protocol but without the threat of public speaking. These results suggest that a social stressor, such as public speaking prior to bedtime, increases cortisol but not ACTH levels suggesting HPA dysregulation in women with IBS. CONCLUSIONS & INFERENCES This response to a social stressor contributes to our understanding of the relationship of stress to symptom expression in IBS.
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Affiliation(s)
- Margaret M Heitkemper
- Dept. of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA
| | - Kevin C Cain
- Dept. of Biostatistics and Office of Nursing Research, University of Washington, Seattle, WA
| | - Wimon Deechakawan
- Dept. of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA
| | - Anne Poppe
- Dept. of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA
| | - Sang-Eun Jun
- Keimyung Unviersity College of Nursing, 1000 Sindang-dong, Dalseo-Gu, Daegu, Korea 704-701
| | - Robert L Burr
- Dept. of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA
| | - Monica E Jarrett
- Dept. of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA
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