Gastrointestinal diseases were significantly associated with sleep disturbances in US adults, with depression serving as a partial mediator, according to a study of 10,626 participants from the National Health and Nutrition Examination Survey 2005-2014.

Gastrointestinal diseases was defined as stomach or intestinal illness with vomiting or diarrhea within the past 30 days. Patients with GI disease had 70% higher odds of trouble sleeping (38% vs 24%) and 80% higher odds of sleep disorders (15% vs 8%) compared with those without GI conditions. They also reported shorter sleep average duration (6.69 vs 6.85 hours) and had significantly higher rates of depression (20% vs 7%). 

Mediation analysis showed depression accounted for 21% of the effect on sleep trouble, 19% on sleep disorders, and 27% on sleep duration. Associations remained consistent across subgroups, including participants without hypertension, without diabetes, with no smoking history, and those with coronary artery disease.

The authors noted that the findings align with evidence supporting bidirectional relationships between GI diseases, sleep disturbances, and depression, potentially mediated by the gut-brain axis through immune and metabolic pathways. "These findings highlight the importance of addressing both gastrointestinal and psychological health in clinical efforts to improve sleep quality." wrote lead author Shicheng Ye of the Third Clinical Medical College of Guangzhou University of Chinese Medicine, and colleagues.

The study controlled for demographic and clinical variables including age, sex, race and ethnicity, education, income, body mass index, lifestyle factors, and various health conditions. Limitations included the cross-sectional design preventing causal inference, reliance on self-reported data, and inability to distinguish between functional and organic gastrointestinal diseases.

Full disclosures can be found in the study.

Source: BMC Gastroenterology