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Can Irritable Bowel Syndrome Cause Insomnia?

by Dale Cudmore | Updated: Jul 12, 2021

Current research shows that while poor sleep predicts next-day irritable bowel syndrome (IBS) symptoms, IBS does not cause sleep problems in the short term (1,2).

However, people with IBS are much more likely to have sleep disorders like insomnia, which suggests that there is a deeper long term link between the two.

Let’s dig into the research a bit to clear things up...

The Link Between IBS and Sleep Disorders

A systematic review of 36 studies looked at the relationship between IBS and sleep disorders (3).

The authors calculated that people with IBS are approximately 2.6 times more likely to develop a sleep disorder than the general population.

Unlike other topics, nearly every study found a consistent elevated risk for sleep disorders, as you can see in the chart below (every event rate mean for each study was greater than 0).

While we’ve seen that poor sleep drives IBS symptoms, it does appear that there can be a cyclical relationship between the two.

IBS often affects mood and wellbeing, which leads to stress and anxiety, 2 of the most common causes of insomnia. In other words, a few nights of bad sleep can trigger IBS symptoms, which then make sleep issues worse, and so on.

An online questionnaire of 1950 university students found that IBS symptom severity is significantly associated with insomnia complaints (4). If not addressed quickly, acute sleep issues could develop into chronic insomnia.

SummaryWhile IBS may not be the initial trigger for sleep issues, evidence shows that people with IBS are much more likely to develop insomnia, suggesting that IBS symptoms contribute to poor sleep.

IBS and Depression

The other most probable explanation for people with IBS being at high risk of developing a sleep disorder is that IBS is linked with depression. Depression is one of the major risk factors of insomnia.

A study analyzed 3429 individuals, of which 11% had an IBS diagnosis. They found that not only were people with IBS more likely to develop depression, IBS severity worsened as depressive symptoms worsened (5).

SummaryDepression has a bidirectional link with insomnia (meaning that either one can lead to each other), and IBS can exacerbate depressive symptoms. This may contribute to the increased risk of insomnia that individuals with IBS have.

How Are Sleep Issues In People With IBS Treated?

IBS still isn’t fully understood, and is directly treated with diet modification currently.

But since poor sleep is the driver of IBS symptom flare-up, it needs to be treated directly.

Not too much research has been done on this specific population, but it appears that you treat sleep issues like insomnia in people with IBS the same as you would in the general population.

One study found that brief behavioral therapy for insomnia (BBT-I), a shortened version of cognitive behavioral therapy, was effective in patients with IBS (6). After 4 weeks:

At follow-up, there were significant differences between groups in measures of sleep quality and insomnia severity...40% of the BBT-I sample reported clinically meaningful drop in symptoms compared to 17% of the control group.

As expected, IBS symptoms like abdominal pain also decreased in those that experienced an improvement in sleep.

SummaryJust as in the general population, insomnia in those with IBS should be treated with a comprehensive plan made by a medical professional. It will likely include some sort of cognitive behavioral therapy, and may include sleep medication if appropriate.

Summary: IBS and Insomnia

People with IBS are much more likely to develop sleep disorders like insomnia.

Initially, it appears that poor sleep causes IBS symptoms, and not the other way around.

However, due to the effect of IBS on mental health, it can lead to long term sleep problems if the sleep issues aren’t addressed quickly.

People with IBS and insomnia will likely need to adjust their diet and improve their approach to sleeping under the guidance of a doctor.

References

  1. Sleep Measures Predict Next-Day Symptoms in Women with Irritable Bowel Syndrome
  2. Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome
  3. Prevalence of sleep disorder in irritable bowel syndrome: A systematic review with meta-analysis
  4. The Association of Insomnia, Perceived Immune Functioning, and Irritable Bowel Syndrome Complaints
  5. The association between irritable bowel syndrome and the coexistence of depression and insomnia
  6. Brief Behavioral Therapy for Insomnia in Patients with Irritable Bowel Syndrome

Medical Disclaimer: The information on SnoozeUniversity.com is not intended to be a substitute for physician or other qualified care. We simply aim to inform people struggling with sleep issues about the nature of their condition and/or prescribed treatment.


About the authorDale is the founder of Snooze University and a sleep researcher. I overcame my sleep issues and now I'd like to help you do the same by summarizing the latest sleep studies for you.