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

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 IBSand 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 lBS and suggested an intrinsic alteration in autonomic and CNS functioning in patients with IBS.