8 Ways to Sleep Better With Ulcerative Colitis
Tomorrow’s big meeting, today’s missed appointments, endless kid concerns—life’s stressors can keep us all from getting a good night’s sleep. Add wrenching gut pain and multiple, middle-of-the-night bathroom trips that come with ulcerative colitis (UC), and consistent, quality shuteye may seem impossible to get. While that time in dreamland is essential for everyone's overall health, when you're dealing with a chronic condition like UC, you need it even more.
Researchers are studying how sleep disturbances, immune function, and inflammatory bowel diseases (IBD) may be related to UC, says Eugene F. Yen, M.D., clinical director at the Center for Crohn’s and Colitis at the NorthShore IBD Center in Evanston, IL. “We know that sleep disturbance can worsen flare-ups and decrease a person’s threshold to cope, due to pain and fatigue.” In other words, a flare-up can ruin your sleep—yet lack of sleep can prevent your body from healing. How do you stop the vicious UC cycle? Follow these steps.
Talk to Your Healthcare Provider
The first step for anyone experiencing a UC flare-up is to identify and treat the underlying symptoms, Dr. Yen says. So make an appointment with your doctor. “A flare-up will cause you to stay up all night, go to bathroom, and have pain,” he says. Tell your physician what might be at the root of your sleep disturbances. “If your IBD is out-of-control, you have to treat that. If you’ve never slept well, or your anxiety or depression is keeping you awake, then you need to address that.”
Eat Earlier in the Day
The time you eat your meals can play a big role in how often you need to use the bathroom in the middle of the night, says Dr. Yen. “Often, people have to go to the bathroom right after they eat. If you typically eat late, try moving up your dinner time,” he advises. If possible, make lunch your largest meal, adds Diane Javelli, R.D., a clinical dietician at the Nutrition Clinic at UW Medical Center–Montlake in Seattle. Not possible? Eat dinner early in the evening and try to consume lighter, more easily digestible foods that are lower in fat and fiber.
Avoid Foods That May Trigger Symptoms
There are certain foods that people with UC should avoid entirely before bed, says Javelli. Some things to avoid within two hours of sleeping include:
- Caffeine, which can stimulate bowel movements and keep you awake
- Spicy foods, including foods with peppers, ginger, or chili powders
- Alcohol, which can disrupt normal sleep cycles and cause loose bowels
- High-sugar foods, including candy or chocolate (try eating treats flavored with Stevia to satisfy a sweet tooth instead)
- Fatty or greasy foods, like a burger and fries from the drive-thru
Adopt Better Sleep Habits
A regular bedtime routine promotes better Zzz’s for everyone, but it may be especially helpful for those with UC. That’s because a nightly ritual signals your body that it’s time to calm down and relax, Javelli explains. Try to hit the hay at approximately the same time each night. In addition, avoid blue-lit screens (laptop, TVs, or smartphone) within one to two hours of sleep, and keep your bedroom quiet, cool, and dark. A bedroom temperature between 60° and 67°F is optimal for sleep, according to the National Sleep Foundation.
Consider Your Sleep Position
Sometimes the way you sleep can worsen symptoms. For example, sleeping on the side where your bowel is most inflamed can cause some people to have diarrhea, Dr. Yen says. “Some patients will realize this and figure out they can only sleep on their stomach, or on their back, or on their left side,” Dr. Yen says. As with other sleep strategies for UC, it may take some trial and error to discover the right sleep position for you.
Know That Natural Remedies Can Keep You Up
Before you try over-the-counter sleep aids, it’s important to look up common side effects, Javelli says, since some natural remedies can cause stomach pain, nausea, and diarrhea. That doesn’t mean you can’t sip a mug of warm herbal tea before bed, just be aware of specific ingredients that may cause potential reactions. For example, magnesium is believed to help some people sleep better but it can also be used as a laxative, which can worsen diarrhea for people with UC. If in doubt, call your doctor to get the green light first.
Use an App to Track Your UC Symptoms
Everyone with UC experiences symptoms and sleep problems differently, which can change over time. That’s why it’s helpful to track your symptoms to get a clear picture of when problems are happening—and what may be causing them. There are a number of tracker apps available that can help you and your doctor identify patterns, Javelli says. She recommends Cara Care, which was developed by doctors and is free for iPhone or iPad users.
Seek Additional Help if You Need It
Sometimes, it takes a multi-discipline approach to tackle sleep problems. People with UC can deal with distressing symptoms that affect quality of life. They can be prone to anxiety and depression, which can both affect sleep, Dr. Yen says. In some cases, it may be helpful to ask your doctor for a referral to a clinical psychologist. “Some UC patients benefit from cognitive-behavioral therapy, which can help address negative thinking patterns or anxiety,” Dr. Yen says.
Study This: UC Help Is on the Way
Feeling exhausted with UC? There’s plenty of new research underway. Kendra Kamp, Ph.D., R.N., is a researcher at the Department of Biobehavioral Nursing and Health Informatics at the University of Washington, Seattle. She studies tools and interventions that help UC patients get a better night’s sleep, with the aim of better understanding the number-one symptom of UC: fatigue. For the latest UC and IBD news, check out the Crohn’s & Colitis Foundation’s blog and keep coming back here to HealthCentral!
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Sleep Quality in Ulcerative Colitis: Associations with Inflammation, Psychological Distress, and Quality of Life: International Journal of Behavioral Medicine (2018). ncbi.nlm.nih.gov/pubmed/30159665
Symptoms among emerging adults with inflammatory bowel disease: a descriptive study: Research in Nursing and Health (2019). onlinelibrary.wiley.com/doi/abs/10.1002/nur.21985
Optimal bedroom temperature for sleep. The National Sleep Foundation. sleep.org/articles/temperature-for-sleep/