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

Canakis, Andrew; Qazi, Taha

doi:10.1007/s11894-020-0746-x

Cited by 30 publications

(19 citation statements)

References 69 publications

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“…Sleep disturbances including sleep adequacy, initiating and maintaining sleep and excessive somnolence or daytime sleepiness are common in the general population, with at least 20% of Australians experiencing severe sleep deficiencies, consistent with our results 30,31 . Being woken from sleep by GI symptoms has historically been thought to be more indicative of organic GI diseases, 32,33 but accumulating evidence suggests that sleep problems are also common in patients with FGIDs including IBS and FD 16‐21 and patients with FGIDs may be awakened by GI symptoms 17,19 . However, few studies have examined whether sleep disturbances are also a feature of people with IBS and FD in the general population who may be free of the biases associated with health care seeking.…”

Section: Discussionsupporting

confidence: 85%

Sleep disturbances in the irritable bowel syndrome and functional dyspepsia are independent of psychological distress: a population‐based study of 1322 Australians

Koloski

Jones

Walker

et al. 2021

Aliment Pharmacol Ther

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Summary Background Psychological distress, strongly associated with functional gastrointestinal disorders (FGIDS), likely plays a central role in the pathophysiology. The role of sleep disturbances in FGIDs is unclear, and an association with psychological factors is uncertain. Aim To determine whether sleep disturbances are associated with irritable bowel syndrome (IBS) and functional dyspepsia (FD) and if a potential association is explained by psychological distress. Methods Adult sample randomly selected from a region in New South Wales, Australia in 2015 who returned a follow‐up mail survey in 2018 (response rate, 60.5%) that contained questions on IBS, FD, sleep (MOS‐Sleep Scale) and psychological distress (Kessler 6 scale). Results Among this population, 10.4% (95% CI 8.8‐12.2) and 17.9% (95% CI 15.9‐20.1) met Rome III criteria for IBS and FD, respectively. The prevalence of any sleep disturbance at least most of the time was common, with a significantly higher prevalence in FGID (IBS and/or FD) compared with the remaining population (41.8% vs 32.2%, P = 0.003). The total sleep problem index was significantly higher for IBS (OR = 1.71 [95% CI 1.29‐2.27], P < 0.0001) (IBS‐diarrhoea predominant and IBS‐mixed but not IBS‐constipation) and FD (OR = 1.80 [1.43‐2.26], P < 0.0001) (both epigastric pain syndrome and postprandial distress syndrome) even after adjusting for age, sex and psychological distress. Conclusion Both IBS and FD, and most of their major subtypes except IBS‐C, are associated with a range of sleep disturbances. These sleep problems do not appear to be explained by psychological factors and may play an independent role in the pathophysiology.

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Section: Discussionsupporting

confidence: 85%

Sleep disturbances in the irritable bowel syndrome and functional dyspepsia are independent of psychological distress: a population‐based study of 1322 Australians

Koloski

Jones

Walker

et al. 2021

Aliment Pharmacol Ther

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“…This latter relationship has been described by others 19 , and may be linked to the burden of living with a chronic disease 38 , or even a physiological response to inflammation mediated by cytokines 30 . Sleep disturbances are recurrent in subjects affected by IBD also suffering for anxiety and depression 5 , worsening patients' quality of life 5,51 . Poor sleep quality has already been associated with fatigue 20 , and the compresence of these two symptoms is considered an alert to deepen not only the presence of psychological disorder, but also of the gastrointestinal disease activity 51 .…”

Section: Discussionmentioning

confidence: 99%

“…Sleep disturbances are recurrent in subjects affected by IBD also suffering for anxiety and depression 5 , worsening patients' quality of life 5,51 . Poor sleep quality has already been associated with fatigue 20 , and the compresence of these two symptoms is considered an alert to deepen not only the presence of psychological disorder, but also of the gastrointestinal disease activity 51 . These two variables, however, lost significance in the multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia, severe anxiety and increased C-reactive protein are associated with severe fatigue in patients with inflammatory bowel diseases

Tasson

Zingone

Barberio

et al. 2021

Sci Rep

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Patients with inflammatory bowel disease (IBD) report fatigue more frequently than healthy population, but the precise mechanisms underlying its presence are unknown. This study aimed to evaluate the prevalence of fatigue in IBD and its relation with potential causative factors. A survey on fatigue, depression, anxiety, sleep disorders, and the presence of sarcopenia and malnutrition, was sent by email to 244 IBD outpatients of the Gastroenterology Unit of Academic Hospital of Padua. Demographics and clinical data, including the levels of fecal calprotectin (FC) and C-reactive protein (CRP), and current pharmacological treatments were obtained from patients’ medical records. Ninety-nine (40.5%) subjects answered the survey. Ninety-two (92.9%) patients reported fatigue, with sixty-six having mild to moderate fatigue and twenty-six severe fatigue. Multivariate analysis showed that abnormal values of CRP (OR 5.1), severe anxiety (OR 3.7) and sarcopenia (OR 4.4) were the factors independently associated with severe fatigue. Fatigue has a high prevalence in subject affected by IBD. Subjects with altered CRP, sarcopenia and severe anxiety appear more at risk of severe fatigue.

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“…Inflammatory bowel disease (IBD) has bilateral interactions with sleep [51]. Given the relationship between sleep deprivation/fragmentation on cytokine regulation and immune dysfunction, it is hypothesized that poor sleep quality worsens overall symptoms of IBD [52,53].…”

Section: Gastrointestinal Systemmentioning

confidence: 99%

“…Subjective and objective measurements of sleep quality and timing should be considered in patients with IBD particularly in those who have frequent inflammatory flares despite otherwise adequate management. An algorithmic approach to sleep assessment in IBD patients has been proposed by Canakis et al [51].…”

Section: Gastrointestinal Systemmentioning

confidence: 99%

Neurologic Manifestations of Systemic Disease: Sleep Disorders

Davis

Ramani

Quigg

2020

Curr Treat Options Neurol

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

Cited by 30 publications

References 69 publications

Sleep disturbances in the irritable bowel syndrome and functional dyspepsia are independent of psychological distress: a population‐based study of 1322 Australians

Sleep disturbances in the irritable bowel syndrome and functional dyspepsia are independent of psychological distress: a population‐based study of 1322 Australians

Sarcopenia, severe anxiety and increased C-reactive protein are associated with severe fatigue in patients with inflammatory bowel diseases

Neurologic Manifestations of Systemic Disease: Sleep Disorders

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