title: Evidence for altered anorectal function in irritable bowel syndrome patients with sleep disturbance.
abstract: OBJECTIVE
  Sleep dysfunction is associated with altered gastrointestinal functioning and the presence of irritable bowel syndrome (IBS). We aimed to investigate whether sleep dysfunction would influence anorectal motility in IBS patients.
  
  
  METHODS
  A total of 16 healthy volunteers and 15 IBS patients underwent anorectal manometry. The anorectal parameters included resting and squeeze sphincter pressure, sensory thresholds in response to balloon distension, and rectoanal inhibitory reflex. Sleep dysfunction was assessed by using the Pittsburgh Sleep Quality Index (PSQI).
  
  
  RESULTS
  IBS patients had a lower threshold volume for urge (p = 0.04) and pain (p = 0.002) as compared with the controls. IBS patients with sleep dysfunction had a significantly lower threshold volume for urge (p = 0.04) and anal sphincter pressure for maximal squeeze (p = 0.048) as compared with those without sleep dysfunction. In IBS patients, the PSQI score significantly correlated with threshold volume for first sensation (r = -0.55; p = 0.03), urge (r = -0.56; p = 0.03) and pain (r = -0.58; p = 0.03).
  
  
  CONCLUSIONS
  IBS patients with sleep dysfunction are characterized by lower thresholds for rectal perception. Sleep disturbance might be associated with anorectal dysfunction and appears to create some degree of rectal hyperalgesia in patients with IBS.
authors.affiliation: Department of Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan. harry.clchen@msa.hinet.net
authors.forename: Chien-Lin
authors.initials: CL
authors.lastname: Chen
authors.forename: Tso-Tsai
authors.initials: TT
authors.lastname: Liu
authors.forename: Chih-Hsun
authors.initials: CH
authors.lastname: Yi
authors.forename: William C
authors.initials: WC
authors.lastname: Orr
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000503:physiopathology*; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008365:Manometry; D011312:Pressure; D012007:Rectum / Q000503:physiopathology*; D012677:Sensation; D012893:Sleep Wake Disorders / Q000150:complications / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D055815:Young Adult