Polysomnographic and actigraphic evidence of sleep fragmentation in patients with irritable bowel syndrome.
OBJECTIVE
To characterize the function and quality of sleep in patients with irritable bowel syndrome (IBS).


METHODS
A prospective study with a historic comparison group.


METHODS
A regional hospital that also serves as a tertiary referral center.


METHODS
Eighteen patients with IBS and a comparison group of 20 matched adults with mild benign snoring.


METHODS
A polysomnography study and a wrist actigraphy study.


METHODS
All subjects underwent sleep studies and completed self-report questionnaires (IBS severity, psychosocial variables, sleep function, and Epworth Sleepiness Scale). Fourteen IBS and 11 comparison patients underwent actigraphy.


RESULTS
The IBS patients had more than 70% less slow-wave stage sleep (4.5 +/- 7.3% vs 19.3 +/- 12.9%; P = 0.006), compensated by increased stage 2 sleep (72.2 +/- 6.6% vs 60.1 +/- 16.8%; P = 0.01). The IBS group had significant sleep fragmentation with a significantly higher arousal and awakening index (P < 0.001), a longer wake period after sleep onset (P = 0.02), and more downward shifts to lighter sleep stages (P = 0.01). The 4-night actigraphy study supported the polysomnography findings. The sleep fragmentation index was significantly higher (P = 0.008) in the IBS group. The IBS patients reported greater daytime sleepiness (9.0 +/- 4.8 vs 6.4 +/- 4.8, Epworth Sleepiness Scale score, P < 0.01) and greater impairment in quality of life, which correlated significantly with the sleep fragmentation indexes. The difference between the groups was not due to differences in baseline anxiety/depression levels.


CONCLUSIONS
Patients with IBS have impaired sleep quality, reduced slow-wave sleep activity, and significant sleep fragmentation. The cause-and-effect relationship of these findings with patients' daytime symptoms should be studied further.
Rotem
Amit Y
AY
Soroka University Medical Center, Beer-Sheva, Israel.
Sperber
Ami D
AD
Krugliak
Pavel
P
Freidman
Bruria
B
Tal
Asher
A
Tarasiuk
Ariel
A
D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications*; D008297:Male; D017286:Polysomnography / Q000295:instrumentation*; D011446:Prospective Studies; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis; D012892:Sleep Deprivation / Q000150:complications* / Q000175:diagnosis*; D012913:Snoring / Q000209:etiology; D011795:Surveys and Questionnaires