Long-term risk of bowel resection and mortality associated with sleep behaviours and sleep pattern in patients with inflammatory bowel disease: a large-scale prospective cohort study

Feb 27, 2026Family medicine and community health

Sleep habits linked to long-term risk of bowel surgery and death in people with inflammatory bowel disease

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Abstract

During a median follow-up of 14.6 years, 498 deaths were reported among 4,262 patients with inflammatory bowel disease (IBD).

Healthy and intermediate sleep patterns are linked to a reduced risk of all-cause mortality compared to poor sleep patterns.
A dose-response relationship exists, with better sleep scores associated with lower mortality risk.
Adequate sleep duration is associated with a 21% lower risk of mortality.
An early is linked to an 18% lower risk of mortality.
Healthy and intermediate sleep patterns show a marginally significant lower risk of bowel resection.
Never or rarely experiencing insomnia symptoms is associated with a 22% lower risk of bowel resection.

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OBJECTIVE: To examine the association between sleep pattern, which integrates sleep duration, and quality, with risk of bowel resection and all-cause mortality in patients with inflammatory bowel disease (IBD) based on a long-term prospective cohort.

DESIGN: Prevalent patients with IBD were categorised into poor (0-2 score), intermediate (3 score) and healthy (4-5 score) based on sleep score. The score assigned 1 point for each of five low-risk sleep behaviours: sleep 7-8 hours per day, early chronotype, no snoring, never/rarely insomnia symptoms and no frequent daytime sleepiness. The primary outcome was all-cause death, with bowel resection as a secondary outcome. Multivariable Cox proportional hazards models were used to explore the association.

SETTING: This study used the data from the UK Biobank with participants recruited in 2006-2010.

PARTICIPANTS: Among 502 411 participants recruited in UK biobank, 4262 cancer-free patients with IBD at baseline were finally included.

RESULTS: During a median of 14.6-year follow-up, 793 received bowel resection and 498 deaths developed. Compared with poor sleep pattern, both healthy (=0.75, 95% CI 0.59 to 0.94) and intermediate (HR=0.77, 95% CI 0.66 to 0.95) sleep groups had reduced mortality risk, with a dose-response relationship across sleep scores (HR=0.89, 95% CI 0.82 to 0.98). Specifically, appropriate sleep duration (HR=0.79, 95% CI 0.66 to 0.95) and early chronotype (HR=0.82, 95% CI 0.68 to 0.98) were associated with 21% and 18% lower mortality risk, respectively. Marginally significant lower risk of bowel resection was observed with healthy (HR=0.86, 95% CI 0.72 to 1.04) and intermediate (HR=0.87, 95% CI 0.73 to 1.03) sleep pattern, with 22% lower risk associated with never/rarely insomnia symptoms (HR=0.78, 95% CI 0.65 to 0.94).

CONCLUSIONS: A healthy sleep pattern, particularly sleep duration and early chronotype, is associated with reduced all-cause mortality risk in patients with IBD, with probably beneficial effect on lowering risk of bowel resection, highlighting the importance of maintaining healthy sleep behaviours for long-term prognosis in IBD.

Key numbers

25%

Decrease in Mortality Risk

Mortality risk reduction associated with healthy sleep patterns compared to poor sleep.

0.79

for Adequate Sleep Duration

for mortality risk associated with adequate sleep duration.

0.82

for Early

for mortality risk associated with having an early .

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Long-term risk of bowel resection and mortality associated with sleep behaviours and sleep pattern in patients with inflammatory bowel disease: a large-scale prospective cohort study

Abstract

Key numbers

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