Sleep and gastric function in irritable bowel syndrome: derailing the brain-gut axis

Abstract

Background: Recently, several studies have shown an alteration in bowel function during sleep in patients with irritable bowel syndrome (IBS), and a recent study also suggests a remarkable increase in rapid eye movement (REM) sleep. These studies have suggested that an alteration in CNS function may play an important role in the pathogenesis of IBS.

Aims: To confirm the presence of an alteration in REM sleep in patients with IBS and to assess the relation between sleep and a non-invasive measure of gastric functioning, the electrogastrogram (EGG).

Patients: Ten patients with IBS and 10 age and sex matched normal volunteers.

Methods: All subjects slept one night in the sleep laboratory and underwent polysomnographic monitoring to determine sleep patterns, and recording of the EGG from surface electrodes.

Results: The IBS group had a notable and significant increase in the percentage and duration of REM sleep (p < 0.05). The control group had a decrease in the amplitude of the dominant EGG frequency from waking to non-REM sleep (p < 0.05), and a subsequent increase in the amplitude from non-REM to REM sleep (p < 0.05). No such changes were noted in the patients with IBS.

Conclusions: Results confirmed the enhancement of REM sleep in patients with IBS and suggested an intrinsic alteration in autonomic and CNS functioning in patients with IBS.

Figure 1

: Typical EGG spectral plots of a normal subject during waking, non-REM and REM sleep.

Figure 2

: Average amplitude of EGG dominant frequency (DF) power across waking and sleep stages in normal subjects and patients with IBS. *p<0.05 v awake; †p<0.05 v non-REM.