Irritable bowel syndrome (IBS) describes a collection of abdominal symptoms including stomach pain and changes to bowel habits without any noticeable underlying pathology. IBS is typically classified in 4 ways based on stool passage frequency:
- predominantly diarrhoea
- predominantly constipation
- present with both diarrhoea and constipation
- Neither diarrhoea nor constipation are experienced at sufficient frequency to fit into one of the above three
Individuals with IBS rarely experience abdominal symptoms continuously; they usually suffer from intermittent, acute attacks. Other symptoms associated with IBS are fatigue, depression, reduced libido, headaches and backaches. . This inevitably reduce the quality of the patient’s life.
It is not entirely clear what causes the onset of symptoms in IBS, although a number of culprits have been suggested including:
- Previous gastrointestinal infection
- Altered communication between the brain and gut (brain-gut axis)as a result of depression, anxiety or other psychological disorders
50% of IBS patients suffer from insomnia. Sleep-deprived IBS sufferers may experience more severe symptoms the next day. For example, female IBS sufferers have reported stomach pain, tiredness and anxiety after a night of poor sleep (source).
A recent study by Patel et al. (source) investigated the impact of sleep patterns on specific IBS symptoms. The researchers measured sleep quality, as well as taking sleep reports from patients, to help determine the association between sleep quality and IBS symptoms.
The study included 50 patients who logged daily GI symptoms, affective state, and sleep patterns for 7 days. The patients (44 women and 6 men) were aged 18 and above, with a mean age of 38.6 years. Sleep patterns were also monitored electronically using an actigraph device worn on the wrist. A control group, with very similar demographics to the IBS group was used as a comparison. There were no significant differences in the two groups in terms of BMI, race, age, gender and tobacco use.
The study found that self-reported sleep quality was lower in the IBS group, fewer subjects reported feeling refreshed upon waking. The reported reason for this difference was rarely associated with GI symptoms. Instead, most reported symptoms such as headache, backache and joint pain. Both IBS and non IBS patient groups slept approx. 7hr but IBS patients reported more awakenings during the night.
Interestingly, the actigraphy reports, which are a more objective measure of sleep, indicated that IBS patients spent more time sleeping than controls. However, they did experience a greater number of awakenings.
The study found that there was a significant link between the number of awakenings during the night and the severity of abdominal pain the next day in IBS patients. Additional, those who experienced more awakenings reported more GI distress the next day. There was no relationship, however, between sleep disturbance and changes in bowel pattern in IBS patients.
In non-IBS patients, there was no relationship between the number of awakenings and abdominal symptoms the next day.
Waking up at night also significantly correlated with non-GI symptoms such as head/backaches, general muscle pain and fatigue, and psychiatric features such as depression and anxiety. Reported quality of life was reduced in individuals who experienced poor sleep.
In conclusion, in IBS sufferers, sleep disruption can aggravate both GI and non-GI symptoms.