The Gut–Sleep Connection in Irritable Bowel Syndrome

Authors

Laura E. Sweatman, University of LynchburgFollow

Specialty

Gastroenterology

Abstract

Sleep quality and sleep disorders are recognized as factors influencing the risk and severity of irritable bowel syndrome (IBS). This review examines the recent evidence linking IBS with sleep disruption and disorders including obstructive sleep apnea, insomnia, circadian rhythm disorders, and restless legs syndrome (RLS). A PubMed search identified studies evaluating the prevalence and mechanisms that may be underlying these associations. This review found an increased risk of IBS among individuals with poor sleep, with up to one-third of IBS patients reporting sleep disturbances. Insomnia, RLS, and circadian rhythm misalignment are linked to heightened IBS risk, with RLS showing a bidirectional relationship. Poor sleep also predicts next-day symptom severity in IBS, while the reverse association is not supported by current evidence. Proposed mechanisms underlying these associations include dysregulation of the gut-brain axis, microbiome changes, dopaminergic dysfunction, hyperalgesia, and psychological factors. Evidence suggests that improving sleep may reduce IBS symptom burden, highlighting the potential value of incorporating sleep management into IBS care. However, a lack of randomized controlled trials limits the ability to establish causality, underscoring the need for further research.

Recommended Citation

Sweatman LE. The Gut–Sleep Connection in Irritable Bowel Syndrome. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2025; 7(3).