Sleep Disturbances Are Commonly Reported Among Patients Presenting to a Gastroenterology Clinic

Ballou, Sarah; Alhassan, Eaman; Hon, Elise; Lembo, Cara; Rangan, V. Kasturi; Singh, Prashant; Hirsch, William; Sommers, Thomas; Iturrino, Johanna; Nee, Judy; Lembo, Anthony

doi:10.1007/s10620-018-5237-7

Cited by 43 publications

(31 citation statements)

References 45 publications

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“…Multivariable model in the present study indicates a significant positive association between GERD and insomnia. A similar result has been observed in previous studies (Jung et al 2010;Iwakura et al 2016;Ballou et al 2018;Ayappa et al 2019;Lei et al 2019). The relation between GERD and insomnia could be bidirectional.…”

Section: Discussionsupporting

confidence: 91%

“…There is increasing evidence that Gastroesophageal Reflux Disease (GERD) is an associated factor for poor sleep quality, insomnia, variations in circadian preferences and increased sleepiness (Iwakura et al 2016;Ballou et al 2018;Ayappa et al 2019). Furthermore, a previous study reported that about one-third of GERD patient are taking sleep medication at least once per week (Ballou et al 2018). Relation of GERD with insomnia patients should be addressed to help primary health-care providers in managing these patients more effectively (Jung et al 2010).…”

Section: Introductionmentioning

confidence: 99%

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Insomnia among primary care adult population in Aseer region of Saudi Arabia: gastroesophageal reflux disease and body mass index correlates

Awadalla

Al-Musa

2019

Biological Rhythm Research

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Insomnia negatively impacts person's quality of life. Little is known about its relationship with gastroesophageal reflux disease (GERD) and body mass index (BMI). Objectives were to evaluate the prevalence of insomnia among primary care adult population; explore its associated factors; examine the relationship between insomnia and BMI categories, and GERD and to ascertain daytime impairments of patients with insomnia. In a survey, representative sample of primary care adult population was screened using questionnaire consists of the following parts: sociodemographic characteristics; habits; validated Arabic versions of Athens insomnia scale, Epworth sleepiness scale, fatigue severity scale and GerdQ questionnaire; participants' height and weight. Out of 3166 surveyed, 1903 suffered insomnia with a prevalence of 60.1%. Through multivariable analysis, insomnia was significantly higher among people having insufficient income (aOR = 1.95), smokers (aOR = 1.47), those drinking >3 coffee cups a day (aOR = 1.24), those having underweight (aOR = 2.06), and those suffering from; chronic disease (aOR = 1.25), fatigue (aOR = 2.10), daytime sleepiness (aOR = 1.57) and GERD (aOR = 1.65). In conclusion, insomnia is a prevalent problem among primary care population. Underweight, chronic diseases and GERD are associated factors. Daily impairment is a significant problem among insomnia patients.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Insomnia among primary care adult population in Aseer region of Saudi Arabia: gastroesophageal reflux disease and body mass index correlates

Awadalla

Al-Musa

2019

Biological Rhythm Research

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“…43 44 Despite unknown causal relationship between impacted sleep and IBS, the close association between gastrointestinal symptoms and sleep disturbances has been identified by others. [45][46][47] The gut microbiota is suggested to play a pivotal role and affect multiple mechanisms in this complex relationship between human sleep disturbances and gastrointestinal disease. 48 49 Smith et al 50 found that gut microbial diversity was positively associated with total sleep time, as well as sleep efficiency which also were positively correlated with phyla richness of Bacteroidetes and Firmicutes.…”

Section: Introductionmentioning

confidence: 99%

Does Fibre-fix provided to people with irritable bowel syndrome who are consuming a low FODMAP diet improve their gut health, gut microbiome, sleep and mental health? A double-blinded, randomised controlled trial

Yan

Murphy

Genoni

et al. 2020

BMJ Open Gastroenterol

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IntroductionA diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) is an effective way to reduce gut symptoms in people with irritable bowel syndrome (IBS). This diet reduces the intake of fermentable fibres, leading to changes of the gut microbiota and insufficient fermentation in the large bowel, resulting in reduced production of short-chain fatty acids (SCFAs), such as butyrate, which has unfavourable implications for gut health, sleep and mental health. This study will examine the effect of Fibre-fix, a supplement containing a mix of dietary fibres, on the human gut microbiome composition, fermentative capacity, sleep, quality of life (QOL) and mental health of people with IBS who consume a low FODMAP diet (LFD).Methods and analysisA randomised, double-blind, placebo-controlled, study design is proposed to examine whether Fibre-fix added to an existing LFD may help modulate gastrointestinal function, improve markers of sleep, mental health and promote QOL in patients with IBS. Participants will provide stool and blood samples, daily bowel symptoms diaries and 3-day diet records. Additionally, they will complete validated questionnaires relating to FODMAP intake, sleep, mental health and QOL before and after a 3-week intervention. Gut health will be assessed via faecal microbiome composition, faecal pH and SCFA levels. Alteration of sleep will be recorded using an actigraphy device worn by all participants over the whole study. Multivariate analysis will be used to examine the gut microbiome and repeated measures Analysis of variance (ANOVA) will be used for dependent variables from questionnaires related to bowel symptoms, stool type, sleep, mental health and QOL to assess the differences between intervention and control groups after adjustment for confounding variables.Ethics and disseminationEthics approval was obtained from the Human Research Ethics Committee of Edith Cowan University (2019-00619-YAN). Results will be disseminated in peer-review journal publications, and conference presentations. Participants will be provided with a summary of findings once the study is completed. If Fibre-fix is shown to result in favourable changes in gut microbial composition, SCFA production, sleep and mental well-being without exacerbating symptoms, this will provide additional dietary management options for those with IBS following an LFD.Trial registration numberACTRN12620000032954.

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“…However, this study was done in the general population and was not specific to patients seeking care for bowel dysfunction . It also lacked detailed assessment of psychiatric and somatic comorbidities, which are very common in patients with functional gastrointestinal disorders . These psychosomatic factors have been shown to be associated with gastrointestinal symptom severity and visceral hypersensitivity, which in turn could be associated with fecal urgency …”

Section: Introductionmentioning

confidence: 99%

“…9 It also lacked detailed assessment of psychiatric and somatic comorbidities, which are very common in patients with functional gastrointestinal disorders. 9,12,13 These psychosomatic factors have been shown to be associated with gastrointestinal symptom severity and visceral hypersensitivity, which in turn could be associated with fecal urgency. 12,14 The goal of this study was to assess the prevalence and burden of fecal urgency in patients with the chief complaint of constipation at a tertiary care center.…”

mentioning

confidence: 99%

Fecal urgency is common in constipated patients and is associated with anxiety

Singh

Takazawa

Rangan

et al. 2019

Neurogastroenterology Motil

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Background Fecal urgency is a symptom generally associated with diarrhea but is also reported by patients with constipation. Our aim was to (a) assess the prevalence and burden of fecal urgency in constipated patients (b) evaluate gastrointestinal and psychiatric predictors of moderate to severe fecal urgency in these patients. Methods Patients presenting consecutively to a tertiary outpatient gastroenterology clinic with constipation were included. Patients were considered to have moderate to severe fecal urgency if ≥50% of bowel movements (BMs) in the past 3 months were associated with fecal urgency. Anxiety, depression, and sleep disturbance were diagnosed using a Patient‐Reported Outcomes Measurement Information System (PROMIS) t‐score of ≥60. Abdominal pain and constipation severity were also assessed using PROMIS questionnaires. Univariable and stepwise logistic regression were used to identify predictors of moderate to severe fecal urgency. Key results Of 139 constipated patients, 70.8% reported experiencing fecal urgency in the past 3 months and 25.8% reported being significantly bothered by it. Moderate to severe fecal urgency was reported by 27% of 139 patients. Frequency of loose stools (OR 1.5, 95% CI 1.1, 2.0) and presence of anxiety (OR 2.3, 95% CI 1.1, 5.0) were independent predictors of moderate to severe fecal urgency. Conclusions and inferences Fecal urgency is common in patients with constipation and is frequently bothersome to many patients. We identified clinical and psychiatric factors associated with moderate to severe fecal urgency in constipated patients with potential therapeutic implications if validated in future studies.

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Sleep Disturbances Are Commonly Reported Among Patients Presenting to a Gastroenterology Clinic

Abstract: Patients presenting to a tertiary care GI clinic report poorer sleep than healthy controls. In general, patients with IBS report the highest rates of sleep difficulties compared to patients with other diagnoses.

Cited by 43 publications

References 45 publications

Insomnia among primary care adult population in Aseer region of Saudi Arabia: gastroesophageal reflux disease and body mass index correlates

Insomnia among primary care adult population in Aseer region of Saudi Arabia: gastroesophageal reflux disease and body mass index correlates

Does Fibre-fix provided to people with irritable bowel syndrome who are consuming a low FODMAP diet improve their gut health, gut microbiome, sleep and mental health? A double-blinded, randomised controlled trial

Fecal urgency is common in constipated patients and is associated with anxiety

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