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

Feb 1, 2020Current gastroenterology reports

Sleep Problems and Fatigue as Important Hidden Symptoms in Inflammatory Bowel Disease

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Poor sleep is linked to depression and reduced quality of life in ulcerative colitis patients.

IBD patients experience less rapid eye movement sleep and Crohn's disease patients have increased lighter sleep.
Circadian misalignment is observed in IBD patients, with associations noted between this misalignment and more aggressive disease in Crohn's disease.
Biologics may have the potential to improve sleep disturbances in IBD patients.
Disturbances in sleep quality may correlate with intestinal inflammation and heightened systemic immune responses.
Poor sleep could serve as a marker for subclinical disease activity in IBD.

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

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