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POOR SUBJECTIVE SLEEP QUALITY PREDICTS SYMPTOMS IN IRRITABLE BOWEL SYNDROME USING THE EXPERIENCE SAMPLING METHOD

Rabia Topan 1, Lisa Vork 2, Heather Fitzke 3, Shraya Pandya 4, Daniel Keszthelyi 2, Jan Cornelis 5, Jason Ellis 6, Lukas Van Oudenhove 7, Maaike Van Den Houte 8, Qasim Aziz 9

Affiliations

1 Queen Mary University London, London, United Kingdom

2 Maastricht University, Eindhoven, Netherlands

3 University College London Hospital, London, United Kingdom

4 Queen Marys University London, London, United Kingdom

5 IMEC, Heverlee, Belgium

6 Northumbria University, Northumbria, United Kingdom

7 Katholieke Universiteit Leuven, Leuven, Belgium

8 Translational Research in Gastrointestinal Disorders (TARGID), Leuven, Belgium

9 Wingate Institute for Neurogastroenterology - Centre for Neuroscience and Trauma, London, United Kingdom

Summary

AI Generated

A prospective study of 80 IBS patients using real-time symptom tracking and actigraphy found that poor subjective sleep quality predicted next-day abdominal pain and lower GI symptoms, but objective sleep measures showed no such relationship.

Poor subjective sleep quality predicted higher next-day abdominal pain (p < 0.040) and lower GI symptom scores (p < 0.032) in cross-lagged analysis, but GI symptoms did not predict subsequent sleep quality.
No significant relationship was found between any objective sleep measure from actigraphy and next-day GI symptoms, suggesting perception of sleep quality may be more influential than measurable sleep parameters.
Among the 80 participants (mean age 37, 89% female, 78% community-recruited), 66% had clinically significant sleep disturbance (PSQI ≥ 8) and 82% screened positive for a sleep disorder, most commonly insomnia.
The study used Experience Sampling Method with ten daily smartphone recordings over seven days plus wrist actigraphy to assess temporal directionality between sleep and symptoms.
Findings support using real-time patient-reported outcomes to study IBS symptom influencers and may guide future research on sleep interventions for GI symptoms.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Sleep disturbances are more common in individuals with Irritable Bowel Syndrome (IBS) compared to healthy subjects. Sleep quality is an independent factor affecting gastrointestinal (GI) symptoms but the directionality of effects is unknown.

Aims & Methods

Our aim was to investigate relationships between subjective sleep quality, objective sleep measures and GI symptoms using actigraphy and the Experience Sampling Method (ESM). Single-centre, prospective, cross-sectional study conducted at the Wingate Institute of Neurogastroenterology in London, from March 2020 to May 2021. IBS patients were recruited from a tertiary neurogastroenterology clinic and the community. GI symptoms and mood were recorded on a smartphone application, ten times per day, over seven consecutive days (i.e. ESM). Subjective sleep quality was recorded every morning to reflect the night before. Objective measures of sleep quality were estimated from wrist-worn actigraphy. Cross-lagged structural equation models were built to assess the directionality of sleep-symptom relationships over time.

Results

Eighty IBS patients completed the study (mean age: 37 (range 20 – 68), 89% female, 78% community). The median IBS - Symptom Severity Score (IBS-SSS) score indicated moderate IBS severity (279 (IQR: 237-350)). Sixty-six % had a Pittsburgh Sleep Quality Index (PSQI) score ≥ 8 indicating a clinically significant sleep disturbance. Eighty-two % (95% CI: 72-90) screened positive for a sleep disorder, most commonly insomnia. Sleep efficiency, measured by actigraphy, was at the lower end of normal range (median: 86% (CI 95%: 85-87). In cross-lagged analysis, poor subjective sleep quality predicted next day abdominal pain (0.036 < p < 0.040) and lower GI symptoms (0.030 < p < 0.032), but not vice versa. Although the direction of the effect was the same for abdominal pain and lower GI symptoms, it was not significant for upper GI symptoms. No significant relationship with GI symptoms was found for any objective sleep measure.

Conclusion

Poor subjective sleep quality is associated with higher next day abdominal pain and lower GI symptom scores in IBS patients, but not vice versa. Objective sleep measures did not predict next day abdominal symptoms, potentially supporting the conclusion that it is the perception of sleep quality which is most influential. This study supports the use of real-time patient reported outcome measures when interpreting potential influencers of IBS symptoms and may be used to guide future research into the effect of sleep interventions on GI symptoms.

Disclosure

DK has received research funding from Grunenthal, Allergan, Will Pharma, Rome Foundation, ZonMw, MLDS, UEG, Horizon 2020, Horizon Europe, and speaker’s fee from Dr Falk (paid to host institution).
QA undergoes consulting work for Takeda Pharmacueticals, and Classado Biosciences Ltd.

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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EPIDEMIOLOGY OF SLEEP QUALITY IN ROME IV IRRITABLE BOWEL SYNDROME (IBS)

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