Poor sleep can affect mental health, which in turn increases the risk of irritable bowel syndrome

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disease, with abdominal pain, bloating, changes in bowel habits and/or stool characteristics as the main clinical manifestations, but no structural or biochemical abnormalities in the gastrointestinal tract. IBS affects about 10% of the world's population and has a significant impact on quality of life, work efficiency and social relationships. It is reported that 37.6% of IBS patients report sleep disorders, but no studies have yet evaluated whether sleep disorders affect the risk of IBS.

In addition, the prevalence of psychological disorders such as anxiety and depression is also high in IBS patients. When evaluating the behavioral and biological factors that affect the development of IBS, the role of psychological distress cannot be ignored. In fact, previous studies have shown that mental health is closely related to sleep behavior. Mental health problems may lead to sleep disorders, and poor sleep behavior can also lead to the occurrence, recurrence and maintenance of mental health problems. However, it is still unclear whether mental health mediates the effect of sleep behavior on the development of IBS, and whether sleep behavior affects the association between mental health and IBS.

In response to the above clinical problems, the National Clinical Research Center for Kidney Diseases of Nanfang Hospital, Southern Medical University, has conducted relevant work, and the research results were recently published in the Journal of Affective Disorders. The study found that healthy sleep scores and mental health are associated with a lower risk of IBS, and sleep scores and mental health mediate each other's effects on the occurrence of IBS. Professor Qin Xianhui of the National Clinical Research Center for Kidney Diseases of Nanfang Hospital, Southern Medical University is the corresponding author of the article, and Dr. Liu Mengyi is the first author.

The study included more than 300,000 middle-aged and elderly participants from the UK Biobank study who did not have IBS at baseline. The participants' sleep quality was scored based on five sleep factors (higher scores indicate better sleep quality), and healthy sleep patterns were defined as: 7-8 hours of sleep per day, early bedtime, never/rarely insomnia, no snoring, and no frequent daytime sleepiness. Psychological distress and neuroticism were determined using the Patient Health Questionnaire (PHQ) and the Eysenck Personality Questionnaire-Revised Short Form, respectively (higher scores indicate worse mental health).

During 12.0 years of follow-up, 5574 cases of IBS were recorded, and the study showed that:

(1) Healthy sleep behaviors and higher healthy sleep scores were associated with a reduced risk of IBS. For every 1 point increase in the healthy sleep score, the risk of IBS was significantly reduced by 19%. Psychological distress and neuroticism significantly mediated 29.4% and 32.4% of the association between healthy sleep scores and IBS, respectively.

(2) Both psychological distress and neuroticism were associated with an increased risk of IBS. For every 1 point increase in psychological distress and neuroticism, the risk of IBS increased significantly by 16% and 11%. Healthy sleep scores mediated 8.3% and 9.7% of the association between psychological distress and neuroticism and IBS, respectively.

(3) Subjects with the lowest healthy sleep scores, the highest mental health scores, and the highest genetic risk of IBS had the highest risk of IBS.

Figure 1 Direct and indirect associations of healthy sleep scores, psychological distress, and neuroticism with the risk of IBS

This large-scale prospective study comprehensively considered the relationship between sleep quality and mental health and the risk of IBS, emphasizing the important clinical value of following healthy sleep patterns and maintaining mental health for preventing IBS in the general population.

References:

Liu M, Ye Z, Wu Q, Yang S, Zhang Y, Zhou C, He P, Zhang Y, Qin

Editor | Liu Mengyi Gan Xiaoqin

Audit | Qin Xianhui

Reprint: Please contact us and indicate the source.

Kidney Health Promotion Study

A small step in scientific communication is a big step in healthy living! Pay attention to the whole chain of kidney disease prevention and control strategies, share the latest research results and dynamics of the Kidney Health Promotion Research Group, open, cooperative, sharing, and win-win! Welcome everyone to subscribe, criticize and correct!