Sleep is a part of our everyday life and an essential process for maintaining overall health. When we sleep our body can regenerate and repair itself. Poor sleep is associated with worse overall health and can even increase the amount of inflammation in the body. What is more, our sleeping patterns can influence the functioning of our gastrointestinal system. IBD, with its alternating remissions and relapses, results in a variety of symptoms among which poor sleeping patterns are a common one. Although the potential impact of the medications used for treating IBD on sleep has been investigated, the assumed relationship, has not been clearly established.
An Australian study published in 2023 demonstrated that the medications used to treat IBD can be associated with sleep quality. The study involved answering an online survey and included a total of 544 respondents. Common medications that participants were taking included opioids, vitamin D, corticosteroids, methotrexate, and biological agents such as Humira.
Opioid use in the general population is a recognised factor contributing to poor sleep particularly due to sleep apnoea, an associated condition causing uncontrollable pauses in breathing. The study has shown that opioid use was correlated with the long-term IBD history and a high severity of the condition. Other studies have already demonstrated that opioid use in people with IBD was linked with poor quality of life.
Infliximab and vitamin D were also found to be linked with poorer sleep but patients taking them had on average a higher body weight. High body weight is associated with poorer sleep in the general population due to increased risk of sleep apnoea.
Corticosteroids can cause problems with sleep and should generally be taken in the morning. In this study it was difficult to assess the link between corticosteroids and sleep. The fact that corticosteroids are used to treat more complex IBD and their known impact on mental health of the patients might have a confounding effect.
Methotrexate has a known link with fatigue, and in this study only a limited number of participants were treated with this medication (8%). Therefore, the researchers were unable to identify any link between methotrexate and sleep quality. However, some previous studies reported such a correlation.
Despite the study potential limitation (an online questionnaire could attract people with sleeping problems), it increases our understanding of the associations between the use of certain medications and sleep in IBD. Of course, further research is recommended to recognise and document the relationship between sleep quality of IBD patients and their medication use. As the studies available to date are correlational, we cannot be certain of the causal relationship between sleep quality and IBD course.
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The studies mentioned in this article could not have been possible without the contribution of hundreds of people with IBD. IBD research is an active area, and you can be a part of it by participating in one of the active studies here.