As many as one in three Americans live with Irritable Bowel Syndrome (IBS), a condition that includes such challenging and sleep-disrupting experiences as stomach pain, cramps, and diarrhea or constipation—or both. It can also involve fatigue, depression, headaches, and backaches.
IBS has no cure. Treatment is mainly about managing symptoms and avoiding triggers—such as stress, gastrointestinal infections, imbalanced gut bacteria (dysbiosis), and certain foods that can set off symptoms.
IBS can also wreak havoc on your sleep. Although sleep disturbances aren’t officially considered among the diagnostic criteria for IBS, one study found some 37.6 percent of people with IBS also have sleep disorders.
Another study found as many as 50 percent of diagnosed individuals are affected by sleep disorders. According to a study of adolescents with IBS, 53.1 percent of the 113 study subjects experienced sleep disorders.
In this article, we’ll go into detail about the relationship between IBS and sleep and offer tips for sleeping better with IBS if you have it.
IBS and sleep: What’s the connection?
Although research is limited on the connection between sleep problems and the GI system, IBS has been linked with poor sleep quality and significant sleep disturbance.
Half of IBS sufferers—particularly women—experience insomnia. In a vicious cycle, those who get poor sleep may have even worse IBS symptoms the next day.
“Poor sleep is common with IBS,” says Amy Archer, RDN, owner of Wellness RD, LLC. “And when someone gets poor sleep, it correlates with IBS pain.”
What’s more, says Nancy Mitchell, RN, contributing writer at Assisted Living, “Sleep is connected with the immune system and is essential for proper internal recovery. As such, lack of sleep contributes to increased inflammation in the gut lining, which tends to exacerbate IBS symptoms.”
A survey of Dutch university students linked IBS pain to taking longer to fall asleep, perceived sleep quality, and more nighttime awakenings. Pain far outranked constipation and diarrhea symptoms as the most influential factor affecting sleep.
IBS and other conditions that affect sleep
Besides IBS pain, other conditions that go hand-in-hand with IBS can also affect sleep. These conditions might include:
- Sleep apnea: This sleep disorder affects about 20 percent of the population. It can interrupt sleep patterns and reduce the quality of sleep. Symptoms include snoring and temporary episodes of stopped breathing. According to the International Foundation for Gastrointestinal Disorders, people with sleep apnea are more likely to have IBS than those without sleep apnea.
- Chronic pain: A national survey conducted in 2021 found that 63 percent of people with IBS have chronic back or neck pain in addition to the bowel pain they have from IBS. Sleep can be less restful because your body focuses on the sources of pain rather than shutting itself down to sleep.
- Anxiety: About 37 percent of people with IBS also have an anxiety-related condition, according to the survey. Those with anxiety often have higher levels of the stress hormone cortisol in their body. Cortisol is what wakes you in the morning—but having high levels of it when you’re trying to sleep can make it difficult to fully relax into slumber.
- Mood disorders: The same survey found that more than one in four people with IBS also live with a mood disorder, including depression and bipolar disorder. Also known as affective disorders, mood disorders can affect how your brain moves through the phases of sleep—a reason sleep issues are considered features of these mental health conditions.
How to sleep better with IBS
Fortunately, you can improve your sleep and IBS symptoms with a few lifestyle changes. If IBS is robbing you of the sleep you need, start with these suggestions:
- Avoid caffeine before bed: Caffeine is a stimulant—not what you need to help you sleep. It can stay in your system for many hours after you partake in coffee or an energy drink. Caffeine can also stimulate your intestines and cause diarrhea. A 2021 study found that people who consumed more than 106.5 mg of caffeine a day had a 47 percent greater chance of developing IBS symptoms than those who consumed less caffeine.
- Increase fiber intake: A large national study linked fiber intake to sleep duration. Adults who reported a “normal” amount of sleep (seven to eight hours) ate 16.6 g of fiber per day—compared with those who reported fewer than five hours of sleep a day and consumed only 13.2 g of fiber per day. Fiber can help improve IBS constipation symptoms as well since soluble fiber helps keep things moving through your intestines.
- Create a comfortable sleep environment: Archer says strategies that can improve your sleep environment include limiting screen time before bed or wearing blue-blocking glasses and sleeping in a cool room. You’ll also want to optimize your sleep area with comfortable bedding, “white noise” to block out distracting sounds, and blackout curtains to keep the room dark.
- Do gentle exercises like yoga: “Prioritize exercise,” says sleep researcher Jeff Kahn, co-founder of Rise Science. It can help with colonic motility, strengthening your circadian clock, and getting sufficient healthy sleep.
- Consider taking melatonin: Research suggests taking 3 mg of melatonin at bedtime may improve IBS abdominal pain. Scientists believe the reason is that melatonin affects intestinal functioning by moving stool along at an even pace, reducing inflammation in your colon, and suppressing pain signals from nerves in the gut. Of course, it’s best to speak with a healthcare professional before adding melatonin supplements to your diet, though they’re considered generally safe.
- Work with your doctor to find a treatment plan that works for you: Be sure to discuss any IBS symptoms affecting your sleep with your healthcare provider. You’ll need to be proactive about it because not all providers ask patients with functional bowel disorders such as IBS about sleep disturbances—and many patients likewise may not mention it to their provider.
Can IBS cause trouble sleeping?
Yes, because the abdominal pain and bowel irregularities related to IBS can prevent you from falling or staying asleep.
Does IBS get worse with lack of sleep?
There’s a vicious cycle whereby IBS can cause insomnia and disrupt your ability to get quality sleep, only to make the abdominal symptoms and related anxiety and tiredness worse the next day because of a lack of sleep.
Can IBS symptoms wake you up at night?
Yes, because nerves in your intestine can cause pain as they’re triggered by the uneven movement of stool passing along the tract.
How should you sleep when you have IBS?
In a word, deliberately. Because you know IBS can rob you of the sleep you need, you can take steps like those suggested above to help ensure IBS doesn’t disrupt your sleep.
These include making necessary dietary changes, keeping to a regular sleep schedule, avoiding such sleep-disrupting stimulants as caffeine, and making a point to exercise to help healthily stimulate your digestive tract.
Learn more about how your gut health affects sleep and what you can do to improve your gut health for better shuteye.