Have IBD and Insomnia? You’re Not Alone

More than one-third of people with inflammatory bowel disease report trouble sleeping, with moderate or worse insomnia. And the more severe their insomnia, the worse the disability related to their IBD, a new study finds.

Poor sleep is common with IBD, says lead researcher Alex Barnes, MD, a gastroenterologist and clinical lecturer at Flinders Medical Centre in Bedford Park, Australia. 

The link between insomnia and IBD has not been studied enough, Barnes says. But insomnia in people with other chronic health conditions has been linked to a poorer quality of life. 

Barnes and colleagues did an online survey of 670 people with IBD in Australia. They found that clinically significant insomnia was significantly tied to active IBD, belly pain, and significant anxiety and depression.

Diagnose and Treat

The study findings suggest people with IBD be screened for trouble with sleep, Barnes says. In the study, people had clinically significant insomnia if they scored a 14 or higher on the Insomnia Severity Index.

Once identified, “treatment for insomnia is readily available — cognitive behavioral therapy for insomnia — through psychologists or even in the form of smartphone applications,” Barnes says. Seeing a sleep specialist is another option and should be considered especially if someone has significant insomnia while their IBD is mild or in remission. 

When to See a Sleep Specialist

Asked when insomnia might be serious enough for a person to see a sleep specialist, Jocelyn Cheng, MD, a spokesperson for the American Academy of Sleep Medicine, says the first step would be to confirm the person has insomnia. This means ruling out another cause of the symptoms, which could include sleep apnea, poor sleep hygiene, or restless legs syndrome. 

Once insomnia is confirmed, it is important to decide if it significantly impacts a person’s quality of life. This can include attending fewer social- or work-related activities or having a hard time driving, making appointments, or running errands, for example. 

If no other reason can be found for the insomnia, or if your quality of life is significantly impacted, a sleep expert is a good idea, says Cheng, who is also senior director of clinical research-neuroscience at Eisai Inc.  

The finding in the study that more severe insomnia — more trouble falling asleep, staying asleep and/or waking up too early — is linked to worse IBD symptoms aligns with evidence from other studies, Cheng says. 

Insomnia could be a learned behavior from when people with IBD have flares and have trouble sleeping that gets carried over to times when IBD is in remission, Barnes says.

Multiple tools to identify insomnia exist, Barnes says, and it would be worthwhile to come up with one specific to IBD in the future. 


European Crohn’s and Colitis Organisation (ECCO) 2023 Congress.

Alex Barnes, MD, gastroenterologist and clinical lecturer, Flinders Medical Centre, Bedford Park, Australia. 

Jocelyn Cheng, MD, spokesperson, American Academy of Sleep Medicine; senior director of clinical research-neuroscience, Eisai Inc.

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