They can influence each other, but it is not yet clear how. Here’s what is known about the link between sleep and intestinal disorders.
It affects a variable share between 15 and 20% of adults and can negatively affect the functioning of the nervous, immune and endocrine systems: it is insomnia, a problem that, if chronic, can be associated with anxiety and depression, obesity, diabetes and cardiovascular problems.
Not only that, sleep disorders can also accompany irritable bowel syndrome, a condition characterized by abdominal cramps, bloating and alterations in intestinal motility.
A two-way bond
About a third of patients with irritable bowel suffer from difficulty falling asleep, reduced sleep duration, frequent awakenings or non-restorative sleep find themselves struggling with falling asleep.
In some cases there seems to be a direct association between poor sleep quality and increased intensity, frequency and severity of gastroenterological symptoms. In addition, irritable bowel often forces night awakenings to run to the bathroom or because of abdominal discomfort.
“Precisely the negative visceral sensations could contribute to creating a condition defined as sleep misperception: the patient feels that he has a light sleep, perceived as wakefulness and therefore has the impression of sleeping little”, explains Marco Angriman, expert in Sleep Medicine in pediatric and adult age of the Neurology and Neurorehabilitation Service for the developmental age of the Bolzano Hospital.
On the other hand, it seems that insomnia may also play a role in the appearance of irritable bowel. “In a recent study – explains Angriman – 33% of patients with insomnia had symptoms of this syndrome. The authors concluded that chronic insomnia sufferers have a higher risk of developing this disease than the general population, but the mechanisms of this association are unknown.
The hypothesis is that insomnia contributes to the development of a condition of visceral hypersensitivity that would lead to greater sensitivity to pain in the intestine. “This interaction would be mediated by abnormal activation of the autonomic nervous system.”
The link between insomnia and irritable bowel therefore seems to be bidirectional, and just as the symptoms of this syndrome can worsen sleep quality, insomnia can in turn increase sensitivity to visceral stimuli and affect intestinal motility. “All this – underlines Angriman – can lead to a vicious circle that is difficult to break”.
Towards new research
A further indication of the link between sleep and irritable bowel is the ability of melatonin (a substance involved both in the regulation of the sleep-wake rhythm and in the modulation of the release of proinflammatory molecules in the intestine) to reduce painful symptoms affecting the intestine.
“The study of the association between insomnia and irritable bowel syndrome, however, suffers from some potentially confounding factors,” Angriman points out, listing the weaknesses of the research conducted to date. “The populations studied are composed mostly of women, who are more predisposed to insomnia, and the parameters evaluated are heterogeneous, as are the tools used in scientific investigations”.
According to the expert, there are still many points to be clarified: “Scientific studies will be adequately set up from a methodological point of view, involving large populations, of both genders, which follow the evolution of patients over time and which analyze both subjective and objective parameters”.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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