title: Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome.
abstract: Sleep disturbances are common, and perhaps are even more prevalent in irritable bowel syndrome (IBS).
  
  
  
  To determine the effect of measured sleep on IBS symptoms the following day, IBS-specific quality of life (IBS-QOL) and non-GI pain symptoms.
  
  
  
  IBS patients' sleep patterns were compared to healthy individuals via wrist-mounted actigraphy over 7 days. Daily bowel pain logs (severity, distress; 10-point Likert) stool pattern (Bristol scale) and supporting symptoms (e.g. bloating, urgency; 5-point Likert) were kept. Validated measures, including the GI Symptom Rating Scale-IBS, Visceral Sensitivity Index, Pittsburgh Sleep Quality Index and the IBS-Quality of Life were collected. Mediation analysis explored the relationship between sleep, mood and bowel symptoms.
  
  
  
  Fifty subjects (38.6 ± 1.0 years old, 44 female; 24 IBS and 26 healthy controls) completed sleep monitoring. IBS patients slept more hours per day (7.7 ± 0.2 vs. 7.1 ± 0.1, P = 0.008), but felt less well-rested. IBS patients demonstrated more waking episodes during sleep (waking episodes; 12.1 vs. 9.3, P < 0.001). Waking episodes predicted worse abdominal pain (P ≤ 0.01) and GI distress (P < 0.001), but not bowel pattern or accessory IBS symptoms (P > 0.3 for each). Waking episodes negatively correlated with general- and IBS-specific QOL in IBS (r = -0.58 and -0.52, P < 0.001 for each). Disturbed sleep effects on abdominal pain were partially explained by mood as an intermediate.
  
  
  
  Sleep disturbances are more common in irritable bowel syndrome, and correlate with IBS-related pain, distress and poorer irritable bowel syndrome-related quality of life. Disturbed sleep effects extend beyond the bowel, leading to worse mood and greater somatic pain in patients with the irritable bowel syndrome.
authors.affiliation: Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: A
authors.initials: A
authors.lastname: Patel
authors.affiliation: Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: S
authors.initials: S
authors.lastname: Hasak
authors.affiliation: Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: B
authors.initials: B
authors.lastname: Cassell
authors.affiliation: Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Ciorba
authors.affiliation: Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: E E
authors.initials: EE
authors.lastname: Vivio
authors.affiliation: Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: C Prakash
authors.initials: CP
authors.lastname: Gyawali
authors.affiliation: Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.|Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.|Gastroenterology Section, John Cochran Veterans Affairs Medical Center, St. Louis, MO, USA.
authors.forename: G S
authors.initials: GS
authors.lastname: Sayuk
mesh_terms: D015746:Abdominal Pain / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D056044:Actigraphy; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004569:Electroencephalography; D004644:Emotions; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D059226:Nociceptive Pain / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult