March 16, 2023 – More than a 3rd of individuals with inflammatory bowel disease report sleep disturbances, with moderate or severe insomnia. And the more severe their insomnia, the more serious the incapacity related to their IBD, a latest study finds.
Poor sleep is common in IBD, says lead researcher Dr. Alex Barnes, a gastroenterologist and clinical lecturer at Flinders Medical Centre in Bedford Park, Australia.
The link between insomnia and IBD shouldn't be well understood, says Barnes, but insomnia in individuals with other chronic diseases is related to poorer quality of life.
Barnes and colleagues conducted an internet survey of 670 individuals with IBD in Australia. They found that clinically significant insomnia was significantly related to energetic IBD, abdominal pain, and significant anxiety and depression.
Diagnosis and treatment
The study's results suggest that individuals with IBD needs to be screened for sleep disorders, Barnes says. In the study, people were considered to have clinically significant insomnia in the event that they scored 14 or higher on the Insomnia Severity Index.
Once insomnia is diagnosed, “there is a treatment option available – cognitive behavioral therapy for insomnia – through psychologists or even in the form of smartphone apps,” says Barnes. Seeing a sleep specialist is an alternative choice and needs to be considered especially if someone is experiencing significant insomnia while their IBD is mild or in remission.
When to see a sleep specialist
When asked when insomnia may be severe enough for an individual to see a sleep specialist, Dr. Jocelyn Cheng, a spokeswoman for the American Academy of Sleep Medicine, says step one is to find out if the person has insomnia. This means ruling out one other explanation for the symptoms, reminiscent of sleep apnea, poor sleep hygiene or restless leg syndrome.
Once insomnia is confirmed, it is vital to find out whether it's significantly affecting an individual's quality of life. For example, this may increasingly mean that they participate less in social or work-related activities or have difficulty driving, making appointments or running errands.
If no other cause might be found in your insomnia or whether it is significantly affecting your quality of life, it's advisable to seek the advice of a sleep specialist, advises Cheng, who can be senior director of clinical research and neuroscience at Eisai Inc.
The study's finding that more severe insomnia – greater difficulty falling asleep, staying asleep and/or waking too early – is related to worse IBD symptoms is consistent with findings from other studies, Cheng says.
Insomnia could also be a learned behavior that individuals with IBD develop during flare-ups and sleep disturbances and that goes away during times of IBD remission, Barnes says.
There are quite a few tools for detecting insomnia, says Barnes, and it might be worthwhile to develop a tool specifically for IBD in the longer term.