Irritable bowel syndrome (IBS) affects between three and 20 percent of the general population and sleep disturbances are among the most reported complaints linked to the condition.
Not only are sleep disturbances recognized as a symptom of IBS, sleep disturbances also have been associated with a higher likelihood of having IBS.
What is the link between IBS and sleep?
A 2017 systematic review set out to evaluate the evidence of sleep disturbances in adults with IBS and their relationship to gastrointestinal (GI) symptoms. A total of 17 studies were included in the review, and involved 1,169 individuals with IBS and 578 without the condition (those without the condition formed the control group).
Subjective sleep quality was typically measured using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries. Objective sleep quality tended to be measured using polysomnography (PSG), although two used actigraphy.
The sleep disturbances linked to IBS
The review identified the following subjective sleep disturbances in those with IBS:
- Poor sleep quality
- Difficulty falling asleep
- Frequent nighttime awakenings
- Daytime dysfunction
Why does IBS keep you up at night?
The review identified the following reasons for nighttime awakenings:
- Abdominal aches, pain, or discomfort
- Need to use the bathroom
- Feeling too hot or cold
- Breathing problems
Interestingly, the review found that when objective sleep data was evaluated, it didn’t always match up with the common subjective complaints listed above. For example, two of the studies that used PSG found no difference in the frequency of nighttime awakenings between those with IBS and controls.
The role of sleep misperception
Since sleep data collected in sleep clinics rarely confirmed the sleep complaints reported by those with IBS, some researchers have suggested that sleep misperception may be to blame for these reported sleep issues.
Typically, someone suffering from sleep misperception (also known as paradoxical insomnia or pseudo-insomnia) will believe their sleep quality is poor, but when it is assessed objectively in a sleep lab, the reality is quite different. For example, someone with the condition may think they are awake when, in fact, they are asleep.
The review identified hyperarousal as being linked to sleep misperception, particularly when it came to complaints regarding how long it took to fall asleep. Since hyperarousal is associated with IBS, this may help to explain the reason for complaints regarding delayed sleep onset.
The authors of the review pointed out that a heightened state of arousal may also allow sensory processing during sleep, leading to the misperception of being awake.
How to improve poor sleep caused by IBS
Although sleep complaints associated with IBS tend to be subjective and hard to replicate in a sleep clinic, they shouldn’t be ignored. Simply believing that you experienced a poor night of sleep is enough to lead to more severe IBS symptoms the following day.
If you feel that your IBS symptoms (such as pain or needing to use the bathroom) are disrupting your sleep, try addressing these first. With that being said, it’s always a good idea to practice good sleep hygiene and reduce stress, worry, and anxiety toward sleep using positive sleep thoughts and cognitive behavioral therapy techniques.
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