Irritable bowel syndrome, or IBS, can take its toll on your days with stomach pain, diarrhea, constipation, and bloating getting in the way of everyday life. But IBS can really be a problem at night when it stops you from getting the sleep you need to feel and function your best.
Unfortunately, it’s even more important to get enough sleep when you have IBS as a lack of sleep can make symptoms worse, creating a vicious cycle. Not to mention that a lack of sleep can tank your overall energy, health, and wellness. And being out of sync with your circadian rhythm (which can happen when you don’t get enough sleep or you sleep at the wrong times — we’ll cover this in more detail soon) can trigger and worsen the condition.
Below, we’ll cover how sleep and your circadian rhythm are linked to IBS, how you can sleep with the condition, and how the RISE app can help you get the shut-eye you need.
Irritable bowel syndrome, commonly known as IBS, is a functional gastrointestinal disorder that causes stomach pain and discomfort as well as altered bowel habits.
Common symptoms of IBS include:
The prevalence of IBS may be up to 45% of the general population.
It’s not entirely clear what causes IBS. Genetics, environmental factors, gut bacteria, and a disorder of the gut-brain axis, or gut-brain connection, may be involved. And we know things like stress, sleep deprivation, and circadian misalignment are linked to the condition.
In short, yes. IBS can make it hard to sleep. In fact, 50% of those with IBS report sleep disturbances, and 74% classify themselves as “poor sleepers.”
If you have IBS you may have sleep issues like:
These sleep problems could be down to chronic pain keeping you up or needing to use the bathroom during the night.
It could also be down to stress and mental health problems related to IBS. In those with IBS, 74% experience overwhelming stress from it, and anxiety and depression are also common in those with the condition. But stress hikes your cortisol levels, keeping you awake, and mood disorders can easily impact your sleep. (We’ve covered how to sleep with anxiety here).
One study compared IBS patients to those without the condition and found those with IBS:
Another small study found those with IBS got more rapid-eye-movement sleep (REM sleep). This could include more arousals and colon movements, which may disrupt sleep.
People with IBS may also suffer from a sleep disorder. It’s thought up to almost 74% of IBS sufferers could have a sleep disorder, and these disorders could be linked to more severe symptoms.
Those with IBS are more likely to have restless leg syndrome and research shows IBS symptom severity is linked to insomnia complaints, sleep onset latency (how long it takes you to fall asleep), and the number of nighttime awakenings. Severity of IBS pain complaints is also linked to being awoken by pain during the night or in the morning.
If you get periods, you may find it especially hard to sleep around this time of the month. Periods come with their own sleep problems, but you may have more IBS symptoms when you’re on your period, too. We’ve covered how to sleep on your period here.
Unfortunately, all this sleep disruption is bad news. Lack of sleep can lead to a whole host of comorbidities like diabetes, obesity, and heart attack.
Wake up with morning symptoms? We’ve covered more on why your stomach hurts in your morning here.
IBS can impact sleep, but sleep can also impact IBS.
Sleep disruption can enhance GI symptoms and visceral hypersensitivity, or increased pain in your visceral organs like your stomach.
Even one night of poor sleep is enough to impact IBS. One study found poorer sleep in women with IBS was linked to higher self-reported stomach pain, anxiety, and fatigue the next day. Another study had similar findings suggesting abdominal pain and distress were worse after a night of disordered sleep. And yet another study found morning IBS symptoms were worse after a night of poor sleep.
Stress can also make IBS symptoms worse as it activates the hypothalamic-pituitary-adrenal (HPA) axis, the connection that modulates our body’s response to stress.
A 2021 study found chronic stress in the past year was associated with GI symptoms and chronic stress in the past five years plus sleeping difficulties three or more nights a week were associated with IBS.
Ongoing sleep problems can also mess with your gut’s microbiome, making it harder to digest food, contributing to digestive issues and IBS.
Sleep apnea, a sleep disorder that causes you to stop breathing temporarily throughout the night, has been linked to IBS and may cause the condition and make symptoms worse. You can learn how to know if you have sleep apnea here.
It’s not all about sleep duration, though. When you get this sleep (and when you do a few other things) matters.
Circadian misalignment is when you’re living at odds with your circadian rhythm — or your body’s roughly 24-hour biological clock.
You have one master clock in your brain that dictates your sleep-wake cycle. This is called the suprachiasmatic nucleus (SCN) and it’s found in the hypothalamus region of the brain. Beyond the SCN, you have clocks in tissues and organs all around your body, including in your gut.
These are known as peripheral clocks. Peripheral clocks tend to run four hours behind your master clock with cues like food intake timing them to the outside world.
But your master clock and peripheral clocks can get out of sync with each other and with the outside world. This might happen if you sleep or eat at odd times or get light exposure, eat, or exercise late at night or during the night.
If that wasn’t complicated enough, there are actually several different circadian rhythms ticking away inside your gut. For example, there’s one that dictates saliva production, one that controls when your digestive tract muscles move, and one controlling stomach acid. When your circadian rhythms get thrown off, the timing of these systems does, too.
Circadian misalignment can cause changes to microbiota composition and the muscles in your digestive system, which could lead to IBS as well as inflammatory bowel disease (IBD) and digestive cancers.
Even seemingly small digestive issues like constipation can be caused by your circadian rhythms being out of whack.
Indeed, research shows nurses working rotating shifts were more likely to have IBS compared to nurses working day shifts. Those working rotating shifts also had higher rates of stomach pain compared to day-shift nurses and night-shift nurses. This was true even when poor sleep quality was taken into account. Although there’s no set definition for sleep quality as a measure of sleep, it shows how constantly being out of sync with your circadian rhythms can mess up your gut independent of sleep.
IBS is also common and rapidly rising among kids and teens. This may be down to the circadian misalignment they face because of early school start times. Teens tend to have late chronotypes (a hard-wired natural tendency to go to sleep and wake up later). But they need to get up early for school. They then often stay up late and eat late into the day, promoting misalignment between their circadian rhythms.
Unfortunately, there may not be a cure for IBS, but there are things you can do to treat the condition, improve your symptoms, and get a good night’s sleep.
As sleep deprivation and disruption can trigger IBS, and make symptoms worse if you already have the condition, focus on getting enough sleep.
“Enough” is different for each of us, though. We all have an individual sleep need, a genetically determined amount of sleep we need at night. The RISE app can work out your sleep need down to the minute.
When you don’t meet your sleep need, you start building up sleep debt, the running total of sleep you’ve missed out on. We measure this over the last 14 nights.
To keep IBS and its symptoms at bay, focus on keeping your sleep debt as low as possible.
If you find you’re carrying a lot of sleep debt, you can pay it down by:
The RISE app can work out how much sleep debt you have and keep track of it as you pay it back.
RISE users on iOS 1.202 and above can click here to view their sleep need.
RISE users on iOS 1.202 and above can click here to view their sleep debt.
Sleep hygiene is the set of daily habits you can do to help you fall and stay asleep at night. This will help you both meet your sleep need and stay in circadian alignment (by being able to fall asleep when your body wants to).
Here’s what to do:
To keep your sleep hygiene on point, you can set up reminders in the RISE app to tell you the best time to do 20+ sleep hygiene habits each day based on your circadian rhythm.
RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications.
As circadian misalignment is so key in IBS, focus on getting and staying in sync. Here’s what to do:
The RISE app predicts your circadian rhythm each day, showing you when your body naturally wants to wake up, wind down for bed, and go to sleep. You can then work to sync up your meal and sleep times to it.
RISE users on iOS 1.202 and above can click here to see their circadian rhythm on the Energy screen.
Your diet has a huge impact on IBS, but that includes both what you eat and when you eat.
More research needs to be done, but for now, a paper published in the World Journal of Gastroenterology recommends those with IBS:
IBS has also been linked to snacking and eating irregularly, so you might want to consider sticking to set meal times and avoiding grazing outside of these.
As well as dietary changes, think about when you eat. Eating at night or close to bedtime can throw off your circadian rhythm, which can make IBS symptoms worse.
Satchin Panda shares in The Circadian Code a study on mice that shows when they ate a processed diet and ate all of the time, they defecated all of the time, too, as if they had IBS. When they were fed on a time-restricted schedule, they used the bathroom less and more rhythmically.
Time-restricted eating refers to eating within a set window of time and fasting outside of this. More research needs to be done to find the ideal window, but it’s suggested a 12-hour window could promote good health. This would mean eating breakfast at 8 a.m., for example, and then being done with dinner by 8 p.m.
Give time-restricted eating a go for at least 12 weeks to see if it improves your symptoms.
We’ve covered more about the best foods for sleep and what time you should stop eating before bed here.
Working out may be the last thing on your mind if you’re suffering from IBS, but it may be beneficial in more ways than one.
Exercise can ease IBS symptoms directly. One systematic review found exercise helped reduce stress, anxiety, and depression in those with IBS, and another study found it helped ease constipation. And another study found low-to-moderate physical activity eased IBS symptoms.
It’s recommended those with IBS do moderate physical activity for at least 30 minutes a day, five or more days a week. Try yoga, walking, cycling, or swimming.
Be warned that strenuous activity may worsen your symptoms, though, so ease into it if you’re not used to working out regularly. If you find this happens, try dialing back the intensity — opt for a brisk walk over a run, for example.
Working out can also help you fall asleep in general, and it’s been shown to help you pass waste, even if you don’t have IBS.
Plus, exercise is also another tool you can use to keep your circadian clocks in check. Make sure you’re working out during the day (bonus points if you do it outside in sunlight) and not too close to bedtime.
We’ve covered the best time to work out here.
Along with sleep and circadian misalignment, stress plays a key role in IBS. It also disrupts your sleep even when IBS symptoms aren’t flaring up.
Work on managing your stress and anxiety to improve both your IBS and sleep. Here’s how:
You can learn more about how to sleep with anxiety here.
RISE users on iOS 1.202 and above can click here to go right to their relaxation audio guide homepage and get started.
RISE users on iOS 1.202 and above can click here to set up their Brain Dump Habit notification
Circadian misalignment can play a huge role in IBS and melatonin supplements could help fix this. Melatonin is a natural hormone your body makes to prime your body for sleep and keep your sleep-wake cycle in check.
Melatonin is also produced in large quantities in the gut and it helps keep circadian rhythms in check there, too. It’s been found to promote gastrointestinal motility, or movement through your digestive system.
Melatonin levels increase when you eat and could help control other circadian rhythms. And it’s also under control of your master clock.
Supplements can shift the timing of your sleep-wake cycle, helping you match it to the outside world and your desired lifestyle.
It’s also thought melatonin supplements could:
A 3-milligram dose of melatonin has been found to ease abdominal pain in those with IBS. One study on postmenopausal women with IBS with constipation found melatonin helped ease pain and bloating in 70% of participants and constipation in 50%.
We’ve covered more on what melatonin does here.
If you do decide to take melatonin supplements to sleep, talk to your healthcare provider to get the ideal dose and timing for you. RISE can also remind you when to take the supplement.
RISE users on iOS 1.202 and above can click here to set up their take melatonin supplements reminder.
Probiotics can improve your diversity of gut bacteria, making digestion run more smoothly.
They’ve been shown to ease constipation and probiotic supplements may also help as they can increase melatonin levels. They’ve been shown to improve pain, bloating, and “satisfaction in bowel habits.”
Want more ways to improve your gut? Here’s how to improve gut health naturally.
If you suffer from constipation IBS (an IBS subtype known as IBS-C, as opposed to IBS-D, which is IBS with diarrhea) you’ve probably been tempted to reach for laxatives.
They’ve been shown to promote bowel movements and get your digestive system back to how it looks in those without IBS, especially when taken at the right time.
Some laxatives take 12 hours to kick, so, when taken at night, they can promote a bowel movement in the morning, promoting healthy circadian rhythms.
Avoid sleep aids, however. Over-the-counter sleep aids are tempting when you can’t fall asleep, but they come with side effects and they’re not a safe long-term solution.
Speak to a doctor about how antidepressants or antispasmodics (to relieve cramps and stomach pain) could help you, or get treatment options for health conditions like sleep apnea and insomnia.
We’ve covered more on what helps with digestion here. And if you suffer from heartburn along with IBS, we’ve covered how to sleep with acid reflux here.
When you get an IBS flare-up in the middle of the night, it’s easy to find yourself awake and struggling to fall back to sleep.
Here’s how to drift back off easily:
We’ve covered more ways to fall back asleep here.
There’s no one sleep position that’s best for IBS. Instead, find the most comfortable position for you.
The best position for digestion in general is sitting or standing up. Be sure to give your body enough time after dinner to get a head start on digestion before you lay down for bed. Aim to finish eating two to three hours before bed.
When you crawl into bed, sleeping on your left side may help speed up digestion as gravity can help waste move along from your small intestines to your large intestines. Left-side sleeping can help reduce acid reflux, and side sleeping in general can help with everything from lower back pain to period pain to sleep apnea.
Sleeping on your front puts pressure on your stomach, which may be painful from bloating, cramps, or general IBS symptoms. If stomach sleeping is usually your go-to, try training yourself to sleep in a different position.
We’ve covered more about the best side to sleep on here, as well as the best sleeping positions to lose weight.
IBS can easily affect your sleep, with everything from cramps to constipation to diarrhea keeping you up. Even just the anxiety around IBS is enough to make getting enough shut-eye hard.
But the problem goes both ways, not getting enough sleep — and sleeping (and eating) at the wrong times for your body clock — can cause and make IBS worse.
To drift off easier, improve your sleep hygiene, eat and sleep in sync with your circadian rhythm, and keep your sleep debt low overall.
The RISE app can help by keeping track of your sleep debt, reminding you when to do 20+ sleep hygiene habits, and predicting your circadian rhythm each day.
Yes, lack of sleep can trigger IBS. Poor sleep can also make IBS worse if you already have the condition. Studies show pain, distress, and general IBS symptoms are worse the next day after a night of poor sleep.
Yes, IBS can cause sleep problems. Pain, cramps, constipation, or diarrhea can keep you up or wake you up in the night, as can the anxiety and stress IBS causes. IBS is also linked to sleep disorders like insomnia, restless leg syndrome, and sleep apnea.
People with IBS don’t necessarily need more sleep than those without IBS. We all need a different amount of sleep — this is called our sleep need. Those with IBS may struggle to meet their sleep needs, however, due to pain, stress, and sleep disorders, so they’re more likely to be sleep deprived. They may need more time in bed because the sleep they do get is fragmented. You can use the RISE app to find out your individual sleep need.
When you have IBS, you should sleep in the position you find the most comfortable and the one that helps you get the most sleep, as sleep is already hard to come by. However, you could try sleeping on your left side, which may help digestion. Avoid laying on your front as this may be painful if you’re bloated.
IBS may be worse when lying down as it’s hard for your body to digest when horizontal as gravity is no longer helping it out. Try finishing your last meal two to three hours before bedtime and sitting or standing up during this time. When you do go to bed, try laying on your left side to aid digestion.
Sleep apnea is linked to IBS. The sleep disorder may cause IBS and make symptoms worse if you already suffer from it. Sleep apnea can also result in serious sleep loss, which may make IBS worse, too.
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