Sleep disorder risk for IBD patients

As many as 1 in 5 people with inflammatory bowel disease (IBD) may also suffer from sleep apnoea.

A new Flinders University-led study recommends people with IBD be screened for obstructive sleep apnoea, a common and debilitating respiratory condition, to improve their long-term health.

Obstructive sleep apnoea (OSA) is linked to a variety of medical conditions including cardiovascular disease, stroke, obesity, Parkinson's, anxiety and depression and gastro-esophageal reflux disease, with Flinders and SA Health researchers developing a new screening tool to identify possible sleep apnoea in IBD patients.

"We are developing a novel screening tool for sleep apnoea which could help identify and manage OSA in IBD patients who already battle with abdominal pain, along with possible daytime sleepiness, obesity, increasing age, smoking and other health and wellbeing problems and long-term risks," says Flinders University sleep researcher Dr Alex Barnes, from the SA Health Southern Adelaide Local Health Network Gastroenterology Department based at the Flinders Medical Centre.

"Our study of 670 IBS patients found moderate to high risk of OSA in about 22.6 per cent of the cohort, many of whom were struggling with their pain burden, weight, smoking, depression and at least mild daytime sleepiness."

The study finding published in Croehn's and Colitis 360 journal (Oxford Academic) recommends the use of a accessible OSA screening for IBD clinics in order to refer patients to a sleep specialist.

"Identification of those with OSA will allow screening for associated cardiovascular complications and commencement of treatments such as continuous positive airway pressure (CPAP)," says co-author Dr Réme Mountifield, also from the SAHLN Gastroenterology Department and Flinders University Sleep Health group, who collaborated with other SA Health and University of Adelaide experts in the new study.

"While the study's online questionnaire had limitations, overseas research has already confirmed OSA is more common in people with IBD, so a simple screening tool for OSA using typical IBD clinic parameters would be a useful way to start addressing this often undiagnosed problem."

IBD is a chronic relapsing-remitting inflammatory condition that is increasing in frequency worldwide.

Associated gastrointestinal symptoms often leads to disrupted sleep leading to poor sleep quality, with active IBD associated with elevated TNF-a (tumor necrosis factor-alpha) levels which may influence the course or severity of OSA.

Simple Novel Screening Tool for Obstructive Sleep Apnea in Inflammatory Bowel Disease (2023) by Alex Barnes, Jane M Andrews, Sutapa Mukherjee, Robert V Bryant, Peter Bampton, Paul Spizzo, Robert J Fraser and Réme Mountifield has been published in Crohn's & Colitis 360, Volume 5, Issue 2, April 2023, DOI: 10.1093/crocol/otad016

Flinders Health and Medical Research Institute (FHMRI) Sleep Health group is involved in a wide range of studies to find cost effective and accurate diagnoses and treatments for sleep disorders including sleep apnoea and insomnia.

Inadequate and disrupted sleep has a negative effect on the health and wellbeing of four out of 10 Australians who are estimated to have sleep problems, with a majority of about 1.5 million adult Australians living with undiagnosed serious sleep disorders.

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