People with IBD evidence more microarousals during sleep architecture assessments

BMJ Open Gastroenterol. 2023 Dec 28;10(1):e001249.doi: 10.1136/bmjgast-2023-001249.


Jessica K Salwen-Deremer 1 2Matthew J Reid 3Sarah J Westvold 2 4Corey A Siegel 2Michael T Smith 3


Author information

1Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA jessica.k.salwen-deremer@hitchcock.org.

2Center for Digestive Health, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.

3Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

4Yale School of Medicine, New Haven, Connecticut, USA.


Objective: Poor sleep is common in inflammatory bowel disease (IBD) and may be associated with overall worse disease outcomes. While the sleep/IBD literature is growing, the data are often self-reported. Further, much of the research using objective measures of sleep architecture, or the overall pattern of sleep depth, rely on single-night assessments, which can be of questionable validity.

Design: Participants with IBD and healthy controls were recruited from Dartmouth-Hitchcock Medical Center as part of a two-phase clinical trial. Sleep architecture was assessed using three nights of in-home electroencephalographic monitoring and scored according to the American Academy of Sleep Medicine guidelines.

Results: Our sample included 15 participants with IBD and 8 healthy controls. Participants with IBD were more psychiatrically complex, with more self-reported insomnia, anxiety and depression. Participants with IBD evidenced greater microarousals than healthy controls. In participants with IBD, microarousals were associated with lower insomnia and greater depression scores. Within IBD, participants with clinically significant insomnia evidenced trend towards lower sleep efficiency, while self-reported disease activity did not significantly impact findings.

Conclusions: The methodology of past research may have impacted findings, including the reliance on single-night assessments and limited generalisability. Future research that uses robust, multinight assessments of sleep architecture in large, diverse samples is clearly warranted, as is research exploring the impact of cognitive and behavioural factors on sleep architecture and arousal.

Trial registration number: NCT04132024.

© Copyright 2013-2024 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.