Open AccessAltered circadian rhythm, sleep disturbance, and gastrointestinal dysfunction: New evidence from rotating shift workers
Author(s) -
Tseng PingHuei,
Wu MingShiang
Publication year - 2016
Publication title -
advances in digestive medicine
Language(s) - English
Resource type - Journals
ISSN - 2351-9800
DOI - 10.1016/j.aidm.2016.05.001
Subject(s) - gerd , sleep disorder , medicine , asymptomatic , epworth sleepiness scale , irritable bowel syndrome , circadian rhythm , gastroenterology , excessive daytime sleepiness , disease , reflux , insomnia , polysomnography , physical therapy , psychiatry , apnea
The relationship between sleep disturbance and various upper or lower gastrointestinal (GI) disorders are complex and poorly understood. The relationship seems to be bidirectional: sleep impairment has been associated with altered GI function and exacerbations of GI symptoms, and these bothersome GI symptoms may also induce or aggravate sleep dysfunction. Notably, sleep disturbance has been associated with several “functional” GI disorders, such as gastroesophageal reflux disease (GERD), functional dyspepsia (FD), and irritable bowel syndrome (IBS) [1]. GERD patients can be woken by gastroesophageal reflux, which helps to facilitate esophageal clearance and symptom relief through positional change or the use of acute antireflux medication. However, night time awakening disrupts sleep and impairs overall sleep quality, leading to daytime sleepiness and reduced work productivity the next day [2]. Furthermore, the associated frequent sleep deprivation, emotional instability, and psychosocial comobidities could also induce visceral hypersensitivity, hyperalgia, and hypervigilance and contribute to the symptomatology in patients who suffer from these functional GI disorders [3]. In a recently published large-scale study enrolling 2936 individuals for an annual health examination, Morito et al [4] found that 233 (7.9%), 254 (8.6%), and 528 (18%) had GERD-, FDand IBSlike symptoms, respectively, after excluding those with organic GI diseases. The severity of daytime sleepiness, in terms of Epworth Sleepiness Scale scores, in the individuals with GERD-, FDand IBS-like symptoms were significantly higher than those observed in the asymptomatic individuals. Moreover, the presence of FDand IBS-like symptoms were found to be significant influencing factors for sleep disturbances. Similarly, disruption of circadian rhythm due to rotating shift work (RSW) in some specific populations, such as hospital nurses or pilots on international flights, has been associated with various IBSlike symptoms, such as abdominal pain, constipation, and