Relationship between enteric migrating motor complex and the sleep cycle

Abstract

To address the question of synchrony between two major biorhythms with a similar periodicity, the cortical rapid eye movement (REM)/non-REM sleep cycle and the enteric migrating motor complex (MMC cycle), we recorded upper small bowel motor activity and sleep activity during nocturnal and diurnal sleep in six healthy subjects. Motility was measured continuously using a fine (2.2 mm OD) and relatively comfortable nasojejunal probe with two pressure-sensitive microtransducers positioned under fluoroscopic control on either side of the ligament of Treitz. Sleep stages were recorded while the subjects slept in a sleep laboratory. Each subject was studied twice; once during normal nocturnal sleep and then after acute reversal of sleep by advancing the time of going to bed by 4 h each night for three nights. The total duration of sleep was similar for diurnal and nocturnal sleep. There was a significantly higher number of REM episodes (P less than 0.001) and REM sleep stage shifts (P less than 0.02) during diurnal (reversed) sleep. During sleep (both diurnal and nocturnal) there was a significant reduction in the MMC cycle length (P less than 0.02, P less than 0.03) and the duration of phase II of the MMC (P less than 0.009, P less than 0.02). The distribution of MMCs among sleep stages and REM sleep was consistent with a random distribution. These data show that periodic activity in the gut is modulated by the presence or absence of sleep, but they also are consistent with the hypothesis that the two cycles are independent and that one is not contingent upon the other.

Comparison of the Small Bowel Motor Response to Solid and Liquid Meals in Man

“…A phase III was seen within the 7-hour period after all solid meals and after 7 The solid and the liquid meal were isocaloric (660 kcal) and had an identical fat content (32%). consecutive 30-min periods [20,21] was seen in all volunteers before they had their morning meal.…”

Aspectos dos efeitos do sono no aparelho digestório

“…Essas contrações se iniciam no estômago e se propagam até o fim do intestino delgado. A periodicidade com que ocorre este complexo motor varia de 90 a 120 minutos (21,22) . Este padrão interdigestivo é interrompido pela ingestão de alimentos, que produz intensa atividade motora, irregular com duração de 3 a 4 horas (21,22) .…”

“…A periodicidade com que ocorre este complexo motor varia de 90 a 120 minutos (21,22) . Este padrão interdigestivo é interrompido pela ingestão de alimentos, que produz intensa atividade motora, irregular com duração de 3 a 4 horas (21,22) . O ritmo de atividade motora intestinal é mais regular durante a noite do que durante o dia.…”

“…Esta duração, que é de 123 ± 62 minutos (média ± EPM) quando a pessoa está acordada, cai para 3 ± 6 minutos durante o sono. Ocorre também diminuição da velocidade da fase III (21,22) . Avaliando-se o índice de motilidade, observou-se que ele foi menor durante todos os estágios do sono, quando comparado com o período de vigília.…”

“…A ingestão de alimentos modifica a motilidade, interrompendo o CMM e provocando contrações repetitivas e intensas. Quando a pessoa dorme após a refeição, a atividade do intestino diminui e o padrão motor interdigestivo retorna mais precocemente, ou seja, a duração dos movimentos do intestino, característicos do período pós-prandial, está diminuída (21,22) . Nesta situação, a fase II do CMM tem duração maior do que aquela observada durante o sono isoladamente.…”