Sleep Characteristics and Rest–Activity Rhythms Are Associated with Gastrointestinal Symptoms Among Adults with Inflammatory Bowel Disease

Mar 21, 2020Digestive diseases and sciences

Sleep patterns and daily activity rhythms linked to digestive symptoms in adults with inflammatory bowel disease

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

The sample included 37 participants, with a mean age of 38 years.

Sleep efficiency averaged 82.91%, while wake after sleep onset was 42.26 minutes.
Sleep efficiency and wake after sleep onset were not associated with disease activity.
Inter-daily stability of rest-activity rhythms (RAR) was negatively associated with heartburn/reflux and gas/bloating symptoms.
Intra-daily variability of RAR was positively associated with heartburn/reflux symptoms.
Disrupted RARs may be linked to gastrointestinal symptoms in individuals with inflammatory bowel disease.

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BACKGROUND: Sleep disturbance is common in inflammatory bowel disease (IBD) and is associated with poorer quality of life and increased disease activity; however, sleep is a multidimensional process, and little is known about specific sleep characteristics and rest-activity rhythms (RARs) in this population.

AIMS: The purposes were to (1) describe sleep characteristics and RARs; (2) compare sleep characteristics and RARs and GI symptoms by disease activity; and (3) describe associations between sleep characteristics, RARs, and GI symptoms among adults with IBD.

METHODS: We conducted a cross-sectional study of adults with IBD. We measured sleep characteristics and RARs (continuous wrist actigraphy); GI symptoms (PROMIS-GI); and disease activity (physicians' global assessment). We conducted cosinor and nonparametric analyses to compute RAR variables and bivariate analyses to address the aims.

RESULTS: The sample included 37 participants [age M = 38 years (SD = 13.8) and 21 (56.8%) female], of whom 23 (60.6%) were in remission. Sleep efficiency [M = 82.91% (SD 5.35)] and wake after sleep onset (WASO) [M = 42.26 min (SD 18.57)] were not associated with disease activity. Inter-daily stability of the RAR was associated with heartburn/reflux (r = - .491, p = .005) and gas/bloating (r = - .469, p = .008). Intra-daily variability of the RAR was associated with heartburn/reflux (r = .421, p = .018).

CONCLUSIONS: People with IBD may have disrupted RARs, which are associated with GI symptoms. Research is needed to improve understanding of these associations and to develop interventions to improve these characteristics in adults with IBD.

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Sleep Characteristics and Rest–Activity Rhythms Are Associated with Gastrointestinal Symptoms Among Adults with Inflammatory Bowel Disease

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