Trying to sleep with irritable bowel syndrome (IBS) pain or discomfort can be challenging, and a lack of sleep can tank your overall energy and health. Despite no medical ‘silver bullet’ for this gut-brain functional gastrointestinal (GI) disorder, adequate rest with a comfortable sleep position can help.
While some IBS patients experience symptoms that come and go, others have severe daily bowel problems that affect work, quality of life, and importantly their ability to sleep.
IBS symptoms include:
- Abdominal cramps and pain
- Alternating constipation and diarrhea
- Sensation of incomplete bowel movements
- Gas and bloating
- Mucus in stools
- Nausea
IBS and sleep
IBS patients may have sleep difficulties such as:
- Struggling to fall asleep
- Waking up often during the night
- Having more light sleep
- Having less total sleep time overall
- Daytime sleepiness
Conditions such as sleep apnea can make IBS symptoms worse. IBS patients are more likely to have restless leg syndrome and studies have shown that IBS symptom severity is linked to insomnia, the number of night-time awakenings, and sleep onset latency (how long it takes you to fall asleep).
IBS has been associated with increased stress, anxiety and depression. Stress can increase cortisol levels, activate the hypothalamic-pituitary-adrenal (HPA) axis, keep you awake and worsen IBS symptoms. A 2021 study found an association between chronic stress and disturbed sleep.
IBS can impact sleep, but sleep can also impact IBS
Sleep difficulties can also mess with your gut’s microbiome, making it more difficult to digest food, contributing to gastrointestinal issues and IBS. Sleep disruption can enhance visceral hypersensitivity, and increase stomach pain.
In a study, poorer sleep was linked to increased stomach pain, anxiety, and fatigue. Another study reported increased abdominal pain and distress after a night of disturbed sleep and yet another study found morning IBS symptoms were worse after a night of poor sleep.
Circadian misalignment occurs when you live at odds with your body’s biological clock.
The master clock in the brain, the suprachiasmatic nucleus (SCN), dictates the sleep-wake cycle. In addition, there are peripheral clocks in other tissues of the body, including the gut that dictate saliva production, one that controls when your digestive tract muscles move, and one controls stomach acid.
If you eat, sleep or exercise at odd times, the master clock and peripheral clocks can get out of sync with each other. Circadian misalignment can cause changes to microbiota composition and the muscles in your digestive system, which could lead to IBS.
Research has shown that nurses working in rotating shifts were more likely to have IBS with higher rates of stomach pain compared to day-shift nurses and night-shift nurses.
Best sleeping positions for IBS
For individuals who experience bloating, sleeping on your stomach could put pressure on organs, and cause discomfort. Sleeping on the right can increase acid reflux and worsen IBS symptoms. Curling up tightly can also make symptoms worse by inhibiting digestion and slowing gas expulsion.
Here are a few sleeping position alternatives that can ease gastrointestinal discomfort:
- On your side
- On your side with a pillow between your legs
- On your back
- On your back with your head raised
- On your back with a pillow under your knees
Sleeping on your back or left side can alleviate IBS. This position allows gravity to do some of the job for you, which can help waste move along from your small intestines to your large intestines.
Left-side sleeping can help reduce acid reflux. You can sleep on your left with a pillow between your legs that allows your spine to stay aligned and relaxes your muscles.
If you lie on your bed and feel your lower back curving up from the mattress, you aren’t getting proper lumbar support. To fix this, put a pillow under your knees. By raising the legs slightly, you flatten the curve in your lower back. However, people with sleep apnea should avoid sleeping on their back.
Tips to improve sleep
- Keep sleep debt low. As sleep disruption and deprivation can trigger IBS, focus on getting adequate sleep.
- Improve your sleep hygiene: Get exposure to natural light during the day and darkness at night, avoid caffeine and alcohol too late in the day, and large meals.
- Limit daytime naps to 30 minutes.
- Consider “white noise”, blackout curtains, wear an eye mask and earplugs, and avoid using electronic devices at night.
- Sync up with your circadian rhythm. Follow consistent sleep patterns and eating schedules. A paper published in the World Journal of Gastroenterology recommends IBS patients must stick to a regular meal pattern and avoid skipping meals , reduce intake of insoluble fibers (like wheat bran), fatty foods, and spicy foods, follow a low FODMAP diet, cut out on triggers such as gluten, and drink plenty of water.
- Exercise in moderation. One systematic review found exercise helped reduce stress, depression, and anxiety in IBS patients, and another study reported that low-to-moderate physical activity such as walking, yoga, or cycling for 30 minutes daily can ease IBD symptoms.
- Lower stress and anxiety. Research has shown that relaxation therapies such as yoga, meditation, diaphragmatic breathing and progressive muscle relaxation can help with IBS.
- Consider melatonin supplements. Melatonin is a hormone the human body that keeps the sleep-wake cycle in check and promotes gastrointestinal motility. Melatonin supplements could help fix circadian misalignment.
- Try probiotics. Probiotics can improve microbial diversity in the gut, ease constipation, and increase melatonin levels.
- Avoid laying down in bed immediately after you eat.
The Bottom Line
IBS can easily disrupt your sleep; however, you may get better sleep by changing your sleeping position, getting in sync with your circadian rhythm, improving your sleep hygiene, and eating the right thing at the right time.
