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Migrating motor complex and sleep in health and irritable bowel syndrome
D A Gorard1, C K Vesselinova-Jenkins, G W Libby
1Department of Gastroenterology, St. Bartholomew's Hospital, London, UK.
Abstract:
The human migrating motor complex (MMC) and sleep cycle have a similar periodicity, and there is some contention as to whether these biorhythms are linked. In irritable bowel syndrome (IBS), episodes of intestinal dysmotility have been described almost exclusively during wakefulness, but IRS patients often complain of poor sleep, and it has been suggested that IBS patients have increased rapid eye movement (REM) sleep. This study sought to identify any associations between sleep stage and small intestinal motility and any objective sleep abnormalities in IBS. Nocturnal motility was recorded from six small intestinal sensors mounted on a fine nasoenteric catheter in eight IBS patients and 10 healthy volunteers. Polysomnography to determine sleep stage was recorded simultaneously. The proportions of time awake, in non-REM and REM sleep was similar in controls and IBS. REM latency did not differ between the two groups despite increased depression in the IBS patients (Hamilton Depression Rating of 8.3 +/- 1.7 in IBS, 3.0 +/- 0.7 in controls, P < 0.01). Nocturnal motility was similar, with phase I occupying most of the MMC cycles. There was no temporal association between MMCs and sleep stage, with no synchrony of phase III for REM episodes. The mean motility index of 4.5 +/- 0.4 during wakefulness was greater than during all sleep stages (P < 0.05). During non-REM sleep stages 1 and 2, motility index of 3.2 +/- 0.3 was greater than 2.3 +/- 0.2 during stages 3 and 4 (P < 0.05), but similar to motility index of 3.3 +/- 0.4 during REM sleep. This sleep architecture and nocturnal small intestinal motility are normal in IBS.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
The study found no link between sleep stages and small intestinal motility in irritable bowel syndrome (IBS) patients. Sleep architecture and nocturnal motility appear normal in IBS, despite common complaints of poor sleep.
Area of Science:
- Gastroenterology
- Sleep Medicine
- Neurogastroenterology
Background:
- The human migrating motor complex (MMC) and sleep cycles share periodicity, prompting investigation into their potential linkage.
- Irritable bowel syndrome (IBS) patients report sleep disturbances and potential alterations in rapid eye movement (REM) sleep, despite intestinal dysmotility primarily occurring during wakefulness.
Purpose of the Study:
- To investigate associations between sleep stages and small intestinal motility.
- To identify objective sleep abnormalities in individuals with IBS.
Main Methods:
- Simultaneous polysomnography for sleep staging and small intestinal motility recording via nasoenteric catheter in 8 IBS patients and 10 healthy volunteers.
- Analysis of sleep architecture (wake, non-REM, REM sleep proportions, REM latency) and motility index during different sleep stages and wakefulness.
Main Results:
- Sleep architecture and REM latency were similar between IBS patients and controls, despite higher depression scores in IBS patients.
- No temporal association was found between migrating motor complexes (MMCs) and sleep stages, including REM episodes.
- Small intestinal motility index was higher during wakefulness than during all sleep stages, and higher in early non-REM sleep than in deep non-REM sleep, but similar to REM sleep.
Conclusions:
- Sleep architecture and nocturnal small intestinal motility are normal in IBS patients.
- The findings do not support a direct link between sleep stages and MMC activity in IBS.
- Despite subjective complaints, objective sleep and motility patterns are not significantly altered in IBS patients in this study.