title: Sleep measures predict next-day symptoms in women with irritable bowel syndrome.
abstract: OBJECTIVE
  Patients with irritable bowel syndrome (IBS) often report sleep disturbances. Previously, we have shown that self-reported sleep difficulties predicted exacerbations of next-day IBS symptoms, mood disturbance, and fatigue. The purpose of this study was to explore whether objectively measured sleep using actigraphy, as well as self-report, predicts next-day symptoms in women with IBS and to explore whether or not symptoms also predict self-report and objective sleep.
  
  
  METHODS
  Women aged 18-45 years with IBS were community-recruited (n = 24, mean age = 32 ± 8 years). Participants completed sleep and IBS symptom diaries for one menstrual cycle and wore Actiwatch-64 actigraphs for 7 days at home. Statistical analyses used generalized estimating equation (GEE) models.
  
  
  RESULTS
  Poorer self-reported sleep quality significantly (p < 0.05) predicted higher next-day abdominal pain, anxiety, and fatigue, but was not significant for gastrointestinal (GI) symptoms or depressed mood. Actigraphic sleep efficiency (SEF) significantly predicted worsening next-day anxiety and fatigue, but not abdominal pain, GI symptoms, or depressed mood. On temporally reversed analyses, none of the symptoms significantly predicted subsequent sleep, except that GI symptoms significantly predicted higher actigraphic sleep efficiency.
  
  
  CONCLUSIONS
  This small exploratory study supports previous findings that self-reported sleep disturbance predicted exacerbation of next-day symptoms in women with IBS and extends this relationship using an objective sleep measure. The study adds further evidence that sleep quality predicts subsequent IBS symptoms, but not the converse. The findings from this small study support the importance of additional longitudinal research to further understand the relationships between sleep and IBS.
authors.forename: Diana Taibi
authors.initials: DT
authors.lastname: Buchanan
authors.forename: Kevin
authors.initials: K
authors.lastname: Cain
authors.forename: Margaret
authors.initials: M
authors.lastname: Heitkemper
authors.forename: Robert
authors.initials: R
authors.lastname: Burr
authors.forename: Michael V
authors.initials: MV
authors.lastname: Vitiello
authors.forename: Jasmine
authors.initials: J
authors.lastname: Zia
authors.forename: Monica
authors.initials: M
authors.lastname: Jarrett
mesh_terms: D015746:Abdominal Pain / Q000150:complications; D000293:Adolescent; D000328:Adult; D005221:Fatigue / Q000150:complications; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications*; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications; D017286:Polysomnography; D012720:Severity of Illness Index; D012890:Sleep; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: actigraphy; gastrointestinal; irritable bowel syndrome; polysomnography; psychological; sleep disturbance; sleep quality; symptoms; women