Sleep Disruption Secondary to Overnight Call Shifts Is Associated With Irritable Bowel Syndrome in Residents: A Cross-Sectional Study

Wells, Malcolm; Roth, L; Chande, Nilesh

doi:10.1038/ajg.2011.486

Cited by 20 publications

(22 citation statements)

References 41 publications

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“…found that nurses working rotating shifts had a significantly higher prevalence of IBS diagnoses and greater abdominal pain compared to their peers working fixed schedules . Similar data among medical residents revealed a 30% increased likelihood of an IBS diagnosis for every additional hour of on‐call sleep deprivation . In the clinical laboratory, Schey and colleagues were able to induce visceral hypersensitivity in GERD patients following sleep deprivation .…”

Section: Discussionmentioning

confidence: 83%

“…39 Similar data among medical residents revealed a 30% increased likelihood of an IBS diagnosis for every additional hour of on-call sleep deprivation. 40 In the clinical laboratory, Schey and colleagues were able to induce visceral hypersensitivity in GERD patients following sleep deprivation. 11 Collectively, these studies offer supportive evidence of a causal relationship of disturbed sleep augmenting visceral hypersensitivity in IBS.…”

Section: Discussionmentioning

confidence: 99%

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Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome

Patel

Hasak

Cassell

et al. 2016

Aliment Pharmacol Ther

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Summary Background Sleep disturbances are common, and perhaps are even more prevalent in irritable bowel syndrome (IBS). Aim To determine the effect of measured sleep on: 1) IBS symptoms the following day, and IBS-specific quality of life (IBS-QOL), and 2) non-GI pain symptoms. Methods IBS patients’ sleep patterns were compared to healthy individuals via wrist-mounted actigraphy over 7 days. Daily bowel pain logs (severity, distress; 10-point Likert), stool pattern (Bristol scale) and supporting symptoms (e.g., bloating, urgency; 5-point Likert) were kept. Validated measures, including the GI Symptom Rating Scale-IBS, Visceral Sensitivity Index, Pittsburgh Sleep Quality Index and the IBS-Quality of Life were collected. Mediation analysis explored the relationship between sleep, mood, and bowel symptoms. Results 50 subjects (38.6±1.0years old, 44 female; 24 IBS and 26 healthy controls) completed sleep monitoring. IBS patients slept more hours per day (7.7±0.2 vs 7.1±0.1, p=0.008), but felt less well-rested. IBS patients demonstrated more waking episodes during sleep (waking episodes; 12.1 vs 9.3, p<0.001). Waking episodes predicted worse abdominal pain (p≤0.01) and GI distress (p<0.001), but not bowel pattern or accessory IBS symptoms (p>0.3 for each). Waking episodes negatively correlated with general- and IBS-specific QOL in IBS (r= −0.58 and −0.52, p<0.001 for each). Disturbed sleep effects on abdominal pain were partially explained by mood as an intermediate. Conclusion Sleep disturbances are more common in IBS, and correlate with IBS-related pain, distress, and poorer IBS-related QOL. Disturbed sleep effects extend beyond the bowel, leading to worse mood and greater somatic pain in IBS patients.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome

Patel

Hasak

Cassell

et al. 2016

Aliment Pharmacol Ther

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“…The large size of the cohorts, prospective design, and prolonged duration of follow-up provide a unique opportunity to examine the association between sleep duration and incident disease with sufficient power to adjust for potential confounders. Second, all our cases were confirmed on chart review by two board certified gastroenterologists, limiting misclassification of outcomes with conditions associated that are often misreported as IBD, including functional bowel disease which has also been associated with poor sleep 6465 . Last, the medical background of the participants also improved the accuracy of reported confounders and health information and facilitated our high follow-up rate.…”

Section: Discussionmentioning

confidence: 86%

Sleep Duration Affects Risk for Ulcerative Colitis: A Prospective Cohort Study

Ananthakrishnan

Khalili

Konijeti

et al. 2014

Clinical Gastroenterology and Hepatology

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Background & Aims Sleep deprivation is associated with production of inflammatory cytokines. Disturbed sleep quality has been associated with increased risk of disease flare in patients with Crohn’s disease (CD) or ulcerative colitis (UC). However, the association between sleep and risk of incident CD and UC has not been previously examined. Methods We conducted a prospective study of women who were enrolled in the Nurses’ Health Study (NHS) I since 1976 and NHS II since 1989 and followed through detailed biennial questionnaires with > 90% follow up. We examined the association of sleep duration reported in 1986 in NHS I and 2001 in NHS II with incident CD and UC, diagnosed through 2010, in NHS I and 2009 in NHS II. Cox proportional hazards models adjusting for potential confounders were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results Among 151,871 women, we confirmed 191 cases of CD (incidence 8/100,000 person-years [p-y]) and 230 cases of UC (incidence 10/100,000 p-y) over 2,292,849 p-y. Compared to women with reported usual sleep durations of 7–8 hrs/day (incidence 8/100,000 p-y), women with reported sleep duration < 6 hrs/day (11/100,000 p-y) or > 9 hrs/day (20/100,000 p-y) had a higher incidence of UC (P<.05).The multivariate HRs for UC were 1.51 (95% CI, 1.10–2.09) for sleep durations < 6 hrs/day and 2.05 (95% CI, 1.44–2.92) for sleep durations > 9 hrs/day, compared to sleep durations of 7–8 hrs/day. In contrast, sleep duration did not modify risk of CD. Duration of rotating night shift work was not associated with CD or UC. Conclusions Based on data from the NHS I and II, less than 6 hrs sleep/day and more than 9 hrs sleep/day are each associated with an increased risk of UC. Further studies are needed to evaluate sleep as a modifiable risk factor in the pathogenesis and progression of IBD.

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“…6 Relationship between GERD and EDS has been reported before, poor sleep quality and sleep disruption were found to be associated with IBS and FD according to previous studies, which indicated that sleep status that was closely connected to gastrointestinal functions and impaired sleep may contribute to FGIDs. [10][11][12]16,[26][27][28] However, studies systematically evaluating relationships between FGIDs and EDS are still insufficient. In our study, ulcer-like dyspepsia, diarrhea-predominant IBS, alternating IBS, functional constipation, and GERD were found to be significantly associated with EDS, which was in consistency with a similar previous study.…”

Section: Discussionmentioning

confidence: 99%

“…4,9 It was reported that sleep problems, such as sleep impairment, sleep disorders, and sleep disruption were associated with functional gastrointestinal disorders (FGIDs), such as functional dyspepsia (FD) and irritable bowel syndrome (IBS). [10][11][12][13][14][15] As a sleep related symptom, EDS was also found to be associated with FGIDs. In China, EDS was significantly more prevalent among participants with gastroesophageal reflux disease (GERD) than those without.…”

Section: Introductionmentioning

confidence: 99%

Association Between Excessive Daytime Sleepiness and Functional Gastrointestinal Disorders: A Population-based Study in China

Chen

Zhao

et al. 2017

J Neurogastroenterol Motil

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Background/AimsSeveral studies have demonstrated that sleep problems are associated with functional gastrointestinal disorders (FGIDs): irritable bowel syndrome (IBS), functional dyspepsia, etc, but the relationship between excessive daytime sleepiness (EDS) and FGIDs has not been systematically studied in the general population. This study aims to explore the relationship between EDS and specific types of FGIDs and the effect of the number of FGIDs on EDS. MethodsA sample of 3600 individuals (aged 18-80 years) was selected from 5 regions in China using a randomized, stratified, multi-stage sampling method. EDS was measured by the Epworth Sleepiness Scale, while gastroesophageal reflux disease (GERD) and other FGIDs were assessed by Reflux Disease Questionnaire and the Rome II diagnostic criteria, respectively. ResultsThe survey was completed by 2906 individuals (response rate: 80.72%), and 644 individuals (22.16%) had EDS. EDS was significantly associated with ulcer-like dyspepsia (OR, 2.50; 95% CI, 1.08-5.79), diarrhea-predominant IBS (OR, 2.00; 95% CI, 1.09-3.66), alternating IBS (OR, 2.32; 95% CI, 1.30-4.13), functional constipation (OR, 1.68; 95% CI, 1.20-2.35), and GERD (OR, 1.72; 95% CI, 1.08-2.72). Risk of EDS increased along with the increasing numbers of FGIDs: with 1 FGID (OR, 1.72; 95% CI, 1.37-2.15); with 2 FGIDs (OR, 2.43; 95% CI, 1.63-3.62); and with 3 or more FGIDs (OR, 3.26; 95% CI,). ConclusionsFGIDs, such as ulcer-like dyspepsia, diarrhea-predominant IBS, alternating IBS, functional constipation, and GERD, were significantly associated with EDS. Those who suffered from more kinds of FGIDs were more susceptible to EDS.

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Sleep Disruption Secondary to Overnight Call Shifts Is Associated With Irritable Bowel Syndrome in Residents: A Cross-Sectional Study

Abstract: Sleep disruption secondary to overnight call in residents was associated with an increased prevalence of IBS.

Cited by 20 publications

References 41 publications

Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome

Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome

Sleep Duration Affects Risk for Ulcerative Colitis: A Prospective Cohort Study

Association Between Excessive Daytime Sleepiness and Functional Gastrointestinal Disorders: A Population-based Study in China

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