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Poor Sleep and IBD: Are They Linked?

Last updated: December 2021

You are not imagining things. That poor night’s sleep may have made your inflammatory bowel disease (IBD) worse. Poor sleep can increase the risk of IBD relapses and flares. And IBD may also disturb your shut-eye.1

Learning more about the close relationship between IBD and sleep may help you manage your symptoms.

Who is at risk for sleep problems with IBD?

A study of 166 people with IBD found roughly 2 out of 3 also felt they slept poorly. The people with IBD who were most likely to report unsatisfying sleep also had:2

  • Depression
  • Lower quality of life
  • IBD-related conditions external to the intestines, affecting the eyes, skin, or joints

This same study found no links between sleep quality and IBD disease activity or subtype. But it did find that some of the sleep disturbances in those with IBD could be tied to the drugs they were taking.2

Crohn’s disease and sleep problems

IBD is a family of conditions that includes Crohn’s disease. One study found 3 out of 4 people with Crohn’s who slept poorly had a higher risk of:3

  • Symptom relapse
  • Surgery
  • Hospitalization

People with Crohn’s disease in this study reported waking up more often due to pain or going to the bathroom. They were also more likely to use benzodiazepine and psychiatric medicines, and to have tissue markers that signal inflammation.3

Ulcerative colitis and sleep problems

IBD also includes ulcerative colitis (UC). People with UC also report high rates of sleep problems.

One study found that people with UC had different sleep patterns than people without it. Those with UC tended to sleep less than 6 hours a night or more than 9 hours. This compares to people without IBD who tend to sleep about 7 to 8 hours a night.4

Poor sleep during UC remission was tied to a greater chance of relapse within 6 months.4

What is the sleep-IBD connection?

Animal studies have shown that sleep deprivation can lead to worse colitis. This is true of both tissue markers and symptoms. Many studies show a 2-way street between sleep and immune diseases, including those with Crohn’s and UC.4

Even when IBD is not in the picture, researchers have made many links between sleep and our immune systems. For instance, good sleep helps the body fight infection.1

Sleep deprivation negatively affects T-cells into the following day. T-cells are part of the immune system that help protect the body from infection. Sleep deprivation is also linked to increases in pro-inflammatory markers such as cytokines. These are cells involved in the immune system.1,5

Experts agree there's a link

Doctors do not yet understand the underlying reasons why sleep affects people with IBD. Some think poor sleep causes changes in cells that cause inflammation or leads to more immune attack cells. Another idea is that poor sleep could lead to a breakdown in tissues in the gastrointestinal tract that then leads to UC or CD.4

What most experts agree upon, however, is that the link exists. And it exists when IBD is both active and inactive.1

Some tips for better sleep with IBD

No need to wait for health researchers to figure it all out. You can take steps now to improve your sleep. Talk to your doctor about whether you should be screened for insomnia or sleep apnea, or see a sleep specialist.6

The most commonly reported sleep problem with IBD is insomnia. Cognitive behavioral therapy (CBT) is a well-regarded treatment for insomnia. CBT for insomnia involves working with a therapist to find:4,6

  • A sleep routine that works for you
  • Eliminating or reducing naps
  • Improving your environment to promote sleep
  • Strategies for what to do when you wake at night

Using CBT for insomnia in people with IBD can reduce pain, depression, and systemic inflammation.6

If you think your sleep habits may be affecting your IBD, talk to your doctor.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The InflammatoryBowelDisease.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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