Why IBD Affects Your Sleep

IBD Can Affect A Person's Amount And Quality Of Sleep

Sleep
You'd think sleep would come naturally, but it often doesn't. You may need to work at your sleep habits. Photo © winnond

It is no surprise to many people who have gastrointestinal disorders such as frequent heartburn, indigestion, or inflammatory bowel disease (IBD) that their condition negatively impacts the quality and duration of their sleep. Sleep could be affected by symptoms of fever, pain, discomfort, or even frequent trips to the bathroom.

Why Sleep Is Important In IBD

Amidst the complications and related conditions associated with gastrointestinal disorders, sleep may be overlooked, and often is.

However, sleep is a critical component of better overall health. Probably the number one factor in getting better sleep is to get control of the underlying problem that is affecting sleep. However, practicing good sleep hygiene may also be helpful in achieving that elusive good night’s sleep.

IBD flare-ups are linked to a lack of sleep. Research has shown that getting poor quality sleep can be a predictor of a coming flare-up. A person with IBD might feel fine but start having problems with sleep and then the next thing that happens is that the IBD starts to become an issue again. IBD experts agree that sleep should be a priority, especially during a flare-up or when at risk for a flare-up. This could mean getting support in regards to sleep, which can come in a variety of forms.

Symptoms Of Insomnia

Sleep Disorders Guide Brandon Peters, MD defines the symptoms of insomnia as:

  • Difficulty falling asleep
  • Difficulty staying asleep
  • Fatigue or daytime sleepiness
  • Poor attention or concentration
  • Mood changes (including worry or reduced motivation or energy)
  • Social or vocational dysfunction (including increased errors or accidents)
  • Tension, headache, or stomach symptoms

Causes Of Insomnia

Insomnia can have a variety of causes, including stress; depression; medication; poor eating habits; use of caffeine, nicotine, or alcohol; and lack of exercise.

Stress and depression are not uncommon in people with chronic health conditions and can make both getting to sleep and staying asleep difficult. Side effects of medication, especially the steroids that are used to treat IBD, can adversely affect sleep.

Eating too close to bedtime can contribute to nighttime heartburn, or as in the case of IBD, precipitate awakening to use the bathroom in the middle of the night. Caffeine and nicotine are both stimulants that can keep you awake. Exercise can tire the body and improve the quality of sleep. Alcohol initially causes drowsiness, but eventually leads to early awakening and disturbed sleep.

Tips For Better Sleep

Use these tips to practice good sleep hygiene and give yourself the best chance for a better night’s sleep:

  • Most adults need 7 to 8 hours of sleep a night, so schedule enough time for sleep into your day
  • If you are taking steroids (such as prednisone), ask your physician about taking all your doses earlier in the day (such as before 4 pm)
  • Eat your last meal of the day earlier in the evening to prevent any symptoms of heartburn from waking you up
  • Monitor your caffeine intake, especially later in the day, and gradually reduce it if necessary
  • Stop smoking, not only to improve sleep but also to prevent the worsening of Crohn’s disease and heartburn
  • Get some form of exercise every day, but be sure to do it at least 3 hours (preferably 5 or 6 hours) before bedtime to avoid being stimulated when it's time to sleep
  • Don’t use alcohol to induce sleep (it can actually cause you to wake prematurely), avoid drinking to excess, and avoid drinking in the several hours before bedtime
  • Try relaxation techniques such as meditation or deep breathing, if you have trouble getting to sleep

Sources:

Ananthakrishnan AN, Long MD, Martin CF, et al. "Sleep disturbance and risk of active disease in patients with Crohn's disease and ulcerative colitis." Clin Gastroenterol Hepatol. 2013 Aug;11:965-971.

Belenky G. "Caffeine and Sleep." National Sleep Foundation 2013. 

Hashash JG, Ramos-Rivers C, Youk A, et al. "Quality of Sleep and Coexistent Psychopathology Have Significant Impact on Fatigue Burden in Patients With Inflammatory Bowel Disease." J Clin Gastroenterol. 2016 Oct 21. 

National Sleep Foundation. "Diet, Exercise and Sleep." National Sleep Foundation 2013. 

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