Decreased sleep associated with constipation among U.S adults
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Both decreased and increased sleep correlated with constipation among U.S. adults in a nationwide survey, with too little sleep persistently increasing risk by 30% after adjusting for other factors, according to data from Digestive Disease Week.
“It’s relevant to ask your patients about sleep because sleep can have an impact of their bowels,” Kyle Staller, MD, MPH, director of the GI Motility Laboratory at Massachusetts General Hospital and Harvard Medical School in Boston, told Healio Gastroenterology and Liver Disease. “When people are having periods where they are having less quality sleep, they may subsequently be at risk for bowel disturbances. We know that among shift workers that IBS symptoms tend to be worse among those that work alternating [shifts] that don’t match with their circadian rhythm and we know that people with IBS also tend to have worsened symptoms after a bad night of sleep. This adds further credence to the idea that sleep and bowels are very intimately connected. With a study like this we can never speak of causality or directionality. Targeting sleep and central mechanisms may have an impact on bowel functions.”
Staller and colleagues identified 14,590 adults who completed both sleep and bowel health questionnaires in the National Health and Nutrition Examination survey. Sleep duration was categorized as normal (7-8 hours), short (<7 hours), and long (>8 hours). Stool form and bowel movement per week were used to define bowel function as either as normal, constipation and diarrhea.
Investigators collected data on known and putative factors correlated with bowel function and sleep, including demographics, comorbid diseases, lifestyle factors, use of constipation-inducing medications and dietary intake. Multinomial logistic regression determined the crude and adjusted odds ratios of the effect of short and long sleep on the risk of constipation or diarrhea.
Investigators found patients with normal sleep duration had a lower prevalence of constipation compared with those with short and long duration of sleep (8.3% vs. 11% and 12.5%, respectively; P < .0001). Shortened sleep duration correlated with 38% increased risk of constipation (COR: 1.38 [1.2-1.59], P < .0001), which was persistent after demographics, comorbidities, lifestyle factors and dietary factories were adjusted (AOR: 1.26 [1.07-1.48], P = .006). Patients with long sleep duration had a 61% increased risk of constipation compared with normal sleep duration (COR: 1.61 [1.31-1.98], P < .0001). This decreased after adjusting for demographics, comorbidities and lifestyle (AOR: 1.3 [1.04-1.62], P = .02) and then eliminated when including dietary factors (AOR: 1.30 [1.04-1.62], P = .02).
Staller noted sleep duration was not correlated with diarrhea. Sleep duration did not impact relationship between comorbidity factors and constipation
“In patients who have bowel disfunction [does] the bowel disfunction has negative impact on their sleep? Or is it that sleep and central mechanisms in the central system are having some impact on the function of the bowels? I think it is likely both,” he said. – by Monica Jaramillo
Reference: Staller, et al. Abstract Sa1711. Presented at: Digestive Disease Week; May 2-5, 2020; Chicago (meeting canceled).
Disclosure: Staller reports no relevant financial disclosures.