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

Koloski, Natasha A.; Jones, Michael; Walker, Marjorie M.; Keely, Simon; Holtmann, Gerald; Talley, Nick

doi:10.1111/apt.16500

Cited by 14 publications

(10 citation statements)

References 43 publications

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“…The prevalence of IBS in our FD population was 45%, which corresponds to the pooled prevalence of 37% (95% CI = 30-45%) reported in a recent meta-analysis (Ford et al, 2010). An increased prevalence of sleep disturbances compared to healthy subjects is found in most studies concerning FD patients (Fass et al, 2000;Lu et al, 2005;Lacy et al, 2011;Futagami et al, 2013a;Shimpuku et al, 2014;Li et al, 2018) but is not consensual for IBS (Kim et al, 2018;Koloski et al, 2021). However, the prevalence varies greatly among studies, depending on the definition used and the specific sleep disorder which is studied.…”

Section: Discussionmentioning

confidence: 99%

Sleep Quality and Insomnia Are Associated With Quality of Life in Functional Dyspepsia

et al. 2022

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BackgroundSleep disturbances are common in patients with functional dyspepsia. Our aim was to assess the relationship between subjective sleep and quality of life and to identify factors associated with impaired sleep in functional dyspepsia.MethodsOne thousand two hundred and twenty patients referred for functional gastrointestinal disorders at a single tertiary care center between end 2017 and June 2019 were studied using a self-administered questionnaire. 355 patients with Rome IV-based functional dyspepsia were identified. Sleep was assessed using both the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI). The severity of dyspeptic symptoms was assessed using the Total Symptom Score (TSS). Quality of life was assessed by the GastroIntestinal Quality of Life Index (GIQLI). Anxiety and depression levels were evaluated using the Hospital Anxiety and Depression (HAD) scale.Key ResultsAmong the 355 patients with functional dyspepsia, 66 (18.6%) patients displayed normal sleep quality whereas 289 (81.4%) patients had altered sleep quality. Functional dyspepsia patients with sleep disturbances were older (48.1 ± 15.4 vs. 41.4 ± 16.0, p = 0.0009), had decreased quality of life (GIQLI: 75.3 ± 18.5 vs. 92.1 ± 15.4, p < 0.0001), greater severity of their symptoms (TSS: 18.9 ± 3.6 vs. 17.2 ± 3.9, p = 0.0007), and higher anxiety and depression scores (HADS: 17.7 ± 7.2 vs. 11.9 ± 5.1, p < 0.0001). A correlation was found between sleep quality and quality of life [r = −0.43 (95% CI: −0.51 to −0.34), p < 0.0001]. Independent factors predicting poor sleep quality were age [OR 1.03 (95% CI = 1.01–1.05), p = 0.006], depression level [OR 1.27 (95% CI = 1.16–1.39); p < 0.0001], and the severity of dyspeptic symptoms [OR 1.13 (95% CI = 1.04–1.22); p = 0.004].Conclusion and InferencesA high prevalence of sleep disturbances was found in patients suffering from functional dyspepsia, with 81% of them having altered sleep quality and 61% having insomnia based on subjective assessment. Altered sleep quality and insomnia were associated with altered quality of life, higher severity of symptoms, and higher anxiety and depression scores in this disorder.

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Section: Discussionmentioning

confidence: 99%

Sleep Quality and Insomnia Are Associated With Quality of Life in Functional Dyspepsia

et al. 2022

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“…There may also be specific neuroendocrine regulatory mechanisms for the visceral hypersensitivity-related symptoms which need to be explored ( 28 ). Sleep disturbances may disrupt the communication between areas in the brain (insula, anterior cingulate cortex, thalamus and prefrontal cortex) and the GI tract, causing GI autonomic dysfunction ( 39 ). Additionally, there may be an inflammatory cytokine mechanism, such as tumor necrosis factor and interleukin−1 and −6 ( 33 , 39 ).…”

Section: Discussionmentioning

confidence: 99%

“…Sleep disturbances may disrupt the communication between areas in the brain (insula, anterior cingulate cortex, thalamus and prefrontal cortex) and the GI tract, causing GI autonomic dysfunction ( 39 ). Additionally, there may be an inflammatory cytokine mechanism, such as tumor necrosis factor and interleukin−1 and −6 ( 33 , 39 ). Patients with sleep disturbances suffer from more severe anxiety and depression associated with constipation and this leads to negative effects by modulating the brain–gut axis and affecting gut motility ( 28 , 29 , 31 , 38 ).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Constipation in Elderly People in Parts of China: A Multicenter Study

Liu

Jia

et al. 2022

Front. Public Health

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PurposeTo investigate the epidemiological characteristics of constipation in people aged 65 years and older in several regions of China.Patients and MethodsA cross-sectional study based on a cluster sampling design was conducted in four cities of China: Tianjin, Xiamen, Cangzhou and Harbin. A total of 5,222 cases (age ≥ 65 years) were recruited, and the survey was conducted via centralized and household questionnaires that included the following: basic demographic characteristics such as sex, age, education, marital status, living status and occupation; social activities; duration of sleep at night; duration of menstruation and delivery times (in females); and if the participant had constipation symptoms, the severity of constipation. Constipation was diagnosed according to the Rome IV criteria.ResultsOf the 5,222 participants, 919 were diagnosed with constipation. The prevalence of constipation was 17.60% in elderly people ≥65 years old. Prevalence increased with age and was significantly higher in females than males (P < 0.05). Prevalence was lower in the manual compared to the non-manual worker group, and significantly increased with decreasing duration of night sleep (P < 0.05). Older age, female sex and shorter sleep duration at night were risk factors for constipation in elderly people.ConclusionThe prevalence of constipation in the elderly people in four cities of China was 17.60%, and was significantly affected by age, sex and sleep duration at night.

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“…Melatonin has been proposed as a potential therapy for IBS ( Lu et al, 2005 ), however, specific mechanisms by which supplementation may improve the symptoms of DGBIs remain largely unknown. There is a strong correlation between DGBIs and sleep disturbances ( Yamawaki et al, 2014 ; Yang et al, 2020 ; Koloski et al, 2021 ), indirectly indicating that circadian systems may be involved in their pathogenesis. Further, lifestyle factors including shift work have been associated with DGBI diagnosis ( Knutsson and Bøggild, 2010 ; Nojkov et al, 2010 ; Kim et al, 2013 ), further supporting the hypothesis that dysregulated circadian cycles contribute to symptom chronicity in these patients.…”

Section: Disorders Of Gut-brain Interactionsmentioning

confidence: 99%

Circadian Rhythms and Melatonin Metabolism in Patients With Disorders of Gut-Brain Interactions

et al. 2022

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Circadian rhythms are cyclic patterns of physiological, behavioural and molecular events that occur over a 24-h period. They are controlled by the suprachiasmatic nucleus (SCN), the brain’s master pacemaker which governs peripheral clocks and melatonin release. While circadian systems are endogenous, there are external factors that synchronise the SCN to the ambient environment including light/dark cycles, fasting/fed state, temperature and physical activity. Circadian rhythms also provide internal temporal organisation which ensures that any internal changes that take place are centrally coordinated. Melatonin synchronises peripheral clocks to the external time and circadian rhythms are regulated by gene expression to control physiological function. Synchronisation of the circadian system with the external environment is vital for the health and survival of an organism and as circadian rhythms play a pivotal role in regulating GI physiology, disruption may lead to gastrointestinal (GI) dysfunction. Disorders of gut-brain interactions (DGBIs), also known as functional gastrointestinal disorders (FGIDs), are a group of diseases where patients experience reoccurring gastrointestinal symptoms which cannot be explained by obvious structural abnormalities and include functional dyspepsia (FD) and irritable bowel syndrome (IBS). Food timing impacts on the production of melatonin and given the correlation between food intake and symptom onset reported by patients with DGBIs, chronodisruption may be a feature of these conditions. Recent advances in immunology implicate circadian rhythms in the regulation of immune responses, and DGBI patients report fatigue and disordered sleep, suggesting circadian disruption. Further, melatonin treatment has been demonstrated to improve symptom burden in IBS patients, however, the mechanisms underlying this efficacy are unclear. Given the influence of circadian rhythms on gastrointestinal physiology and the immune system, modulation of these rhythms may be a potential therapeutic option for reducing symptom burden in these patients.

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

Cited by 14 publications

References 43 publications

Sleep Quality and Insomnia Are Associated With Quality of Life in Functional Dyspepsia

Sleep Quality and Insomnia Are Associated With Quality of Life in Functional Dyspepsia

Epidemiology of Constipation in Elderly People in Parts of China: A Multicenter Study

Circadian Rhythms and Melatonin Metabolism in Patients With Disorders of Gut-Brain Interactions

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