Sleep Characteristics and Rest-Activity Rhythms Are Associated With Gastrointestinal Symptoms Among Adults With Inflammatory Bowel Disease

Dig Dis Sci. 2020 Mar 19. doi: 10.1007/s10620-020-06213-6. Online ahead of print.

Samantha Conley 1, Sangchoon Jeon 2, Vanessa Lehner 2, Deborah D Proctor 2, Nancy S Redeker 2


Author information

1Yale School of Nursing, 400 West Campus Dr., Orange, CT, 06477, USA. samantha.conley@yale.edu.

2Yale School of Nursing, 400 West Campus Dr., Orange, CT, 06477, USA.

PMID: 32193859

DOI: 10.1007/s10620-020-06213-6


Background: Sleep disturbance is common in inflammatory bowel disease (IBD) and is associated with poorer quality of life and increased disease activity; however, sleep is a multidimensional process, and little is known about specific sleep characteristics and rest-activity rhythms (RARs) in this population.

Aims: The purposes were to (1) describe sleep characteristics and RARs; (2) compare sleep characteristics and RARs and GI symptoms by disease activity; and (3) describe associations between sleep characteristics, RARs, and GI symptoms among adults with IBD.

Methods: We conducted a cross-sectional study of adults with IBD. We measured sleep characteristics and RARs (continuous wrist actigraphy); GI symptoms (PROMIS-GI); and disease activity (physicians' global assessment). We conducted cosinor and nonparametric analyses to compute RAR variables and bivariate analyses to address the aims.

Results: The sample included 37 participants [age M = 38 years (SD = 13.8) and 21 (56.8%) female], of whom 23 (60.6%) were in remission. Sleep efficiency [M = 82.91% (SD 5.35)] and wake after sleep onset (WASO) [M = 42.26 min (SD 18.57)] were not associated with disease activity. Inter-daily stability of the RAR was associated with heartburn/reflux (r = - .491, p = .005) and gas/bloating (r = - .469, p = .008). Intra-daily variability of the RAR was associated with heartburn/reflux (r = .421, p = .018).

Conclusions: People with IBD may have disrupted RARs, which are associated with GI symptoms. Research is needed to improve understanding of these associations and to develop interventions to improve these characteristics in adults with IBD.

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