Chronotype, social jet lag, sleep debt and food timing in inflammatory bowel disease

Abstract

The preference of the sleep/wake cycle can be grouped into categories or chronotypes. Inflammatory bowel disease (IBD) has been linked to poor sleep quality which correlates with disease severity. Social jet lag (SJL) is the difference between sleep timing on work and free days and is a marker for circadian misalignment which has been linked to increased inflammation. We investigated whether chronotype, SJL, sleep debt (SD), and food timing were associated with an IBD specific complications and a lower quality of life. Overall, 191 subjects (115 IBD subjects and 76 healthy controls (HC)) completed the Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), Munich ChronoType Questionnaire (MCTQ), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and a structured Food Timing Questionnaire. Later chronotype (by MEQ) was associated with a worse SIBDQ (r = -0.209; P < 0.05). SJL was increased in IBD at 1.32 h ± 1.03 vs. 1.05 h ± 0.97 in HC, P < 0.05, when adjusted for age. SJL (>2 h) was present in 40% of severe/complicated Crohn's patients (fistulizing or structuring Crohn's or history of Crohn's related surgery) compared to only 16% of uncomplicated Crohn's patients (P < 0.05). Sleep debt was increased in IBD subjects compared to HC at 21.90 m ± 25.37 vs. 11.49 m ± 13.58, P < 0.05. IBD subjects with inconsistent breakfast or dinner times had lower SIBDQ scores (4.78 ± 1.28 vs. 5.49 ± 1.02, P < 0.05; 4.95 ± 0.31 vs. 5.42 ± 0.32, P < 0.05 respectively). In summary, later chronotype, and markers of circadian misalignment (social jet lag, sleep debt, and inconsistent meal timing) were associated with IBD disease specific complications and/or lower quality of life.

Differential Sleep Traits Have No Causal Effect on Inflammatory Bowel Diseases: A Mendelian Randomization Study

“…Animal studies showed that sleep disorders promoted colonic inflammation and worsened the severity of colitis ( Preuss et al, 2008 ; Tang et al, 2009 ). Clinical studies showed a correlation of sleep disorders with IBD, in which a significant decrease in sleeping time and sleeping efficiency was closely related to the development and disease activity of IBD ( Chakradeo et al, 2018 ; Chrobak et al, 2018 ; Jarasvaraparn et al, 2019 ; Marinelli et al, 2020 ). A recent systematic review and meta-analysis confirmed the association between poor sleep quality and increased risk of IBD activity ( Hao et al, 2020 ).…”

Effects of partial sleep deprivation on dietary energy intake in a healthy population: a systematic review and meta-analysis

“…Some studies have reported on energy intake as obtained through snacks (29,31) and during dinner (24,29,31); however, measurement times were so heterogeneous that it was not possible to draw any conclusions in this regard. It is important to point out that alterations in meal timing have been associated with inflammatory markers and changes in body weight (9,19).…”

“…In addition, it is necessary to know if the increase in energy intake is related to a specific meal timing. Breakfast irregularity, for example, has been associated with inflammation and change in body weight (19). Nutritional strategies can be implemented focused on the meal of greater intake and, thus, prevent weight gain in a population exposed to a short night's sleep.…”

Circadian rhythms: a regulator of gastrointestinal health and dysfunction

“…However, a polymorphism in the molecular circadian clock gene Per3 is associated with increased use of immunosuppressive drugs and stricturing/fistulizing phenotype in CD [123]. In addition, some IBD patients, especially those with CD, have evidence of circadian disruption and social jet lag that is associated with a more aggressive CD phenotype (fistulizing/stricturing) [124,125]. While there are data to support that IBD patients have circadian rhythm disruption, additional studies are needed.…”