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Sleep Duration and Daytime Napping in Relation to Incident Inflammatory Bowel Disease: A Prospective Cohort Study

10:34 05 June in Blog

Sleep plays an important role in maintaining physical and psychological health1. Reduced sleep duration has been linked to impaired physiological and mental functions2, and cancers3. A recent review has also found that sleep dysregulation has been associated with gastrointestinal dysfunction and inflammation4, including inflammatory bowel disease (IBD)5.

A prospective study found that a sleep duration less than 6 hours or more than 9 hours/day is associated with an increased risk of ulcerative colitis (UC)6. On the other hand, a case-control study found that long sleep (>8 hours/day) but not short sleep (<7 hours/day) is associated with increased risk of UC and Crohn’s disease (CD) compared to 7–8 sleep hours/day7.

This was a prospective cohort study8 based on the UK Biobank conducted to examine the associations of sleep duration and daytime napping with the risk of incident of CD and UC. It included 488,326 participants from the UK biobank study. Sleep duration and daytime napping were assessed through a touchscreen questionnaire.

A total of 2604 incident IBD cases, including 806 incident CD cases, and 1798 incident UC cases, were diagnosed in a median follow-up of 12.0 (interquartile range, 11.2, 12.7) years. Compared to participants without incident IBD, those with incident IBD were more likely to be males with shorter sleep duration, higher frequency of daytime napping, higher levels of CRP, and higher risk of sleep disorders (p < 0.05).

Compared with individuals with 7-hour sleep duration, the hazard ratio (HR) of IBD, CD and UC were 1.55 (95% confidence interval [CI], 1.33, 1.81), 1.74 (95% CI, 1.33, 2.27) and 1.47 (95% CI, 1.22, 1.78) for those with 5-hour sleep duration, respectively. Positive associations were observed of daytime napping with risks of IBD, CD and UC; the HR of IBD, CD and UC was 1.13 (95% CI, 1.05, 1.23), 1.25 (95% CI, 1.08, 1.44) and 1.09 (95% CI, 0.99, 1.20) for those with daytime napping habit, respectively.

As a conclusion, this study showed a positive association between short sleep duration and daytime napping and IBD risk. Increased level of C-reactive protein (CRP), inteleukin-6, and tumor necrosis factor may contribute to the inflammatory processes induced by inadequate sleep duration9,10.


1.         Irwin MR. Sleep and inflammation: partners in sickness and in health. Nat Rev Immunol. 2019;19(11):702-715. doi:10.1038/s41577-019-0190-z

2.         Scott J, Kallestad H, Vedaa O, Sivertsen B, Etain B. Sleep disturbances and first onset of major mental disorders in adolescence and early adulthood: A systematic review and meta-analysis. Sleep Med Rev. 2021;57:101429. doi:10.1016/j.smrv.2021.101429

3.         Ai S, Zhang J, Zhao G, et al. Causal associations of short and long sleep durations with 12 cardiovascular diseases: linear and nonlinear Mendelian randomization analyses in UK Biobank. Eur Heart J. 2021;42(34):3349-3357. doi:10.1093/eurheartj/ehab170

4.         Parekh PJ, Oldfield Iv EC, Challapallisri V, Ware JC, Johnson DA. Sleep disorders and inflammatory disease activity: chicken or the egg? Am J Gastroenterol. 2015;110(4):484-488. doi:10.1038/ajg.2014.247

5.         Orr WC, Fass R, Sundaram SS, Scheimann AO. The effect of sleep on gastrointestinal functioning in common digestive diseases. Lancet Gastroenterol Hepatol. 2020;5(6):616-624. doi:10.1016/S2468-1253(19)30412-1

6.         Ananthakrishnan AN, Khalili H, Konijeti GG, et al. Sleep Duration Affects Risk for Ulcerative Colitis: A Prospective Cohort Study. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2014;12(11):1879-1886. doi:10.1016/j.cgh.2014.04.021

7.         van der Sloot KWJ, Weersma RK, Alizadeh BZ, Dijkstra G. Identification of Environmental Risk Factors Associated With the Development of Inflammatory Bowel Disease. J Crohns Colitis. 2020;14(12):1662-1671. doi:10.1093/ecco-jcc/jjaa114

8.         Yuan S, Sun Y, Tan X, et al. Sleep duration and daytime napping in relation to incident inflammatory bowel disease: a prospective cohort study. Aliment Pharmacol Ther. 2023;57(5):475-485. doi:10.1111/apt.17285

9.         Smagula SF, Stone KL, Redline S, et al. Actigraphy- and Polysomnography-Measured Sleep Disturbances, Inflammation, and Mortality Among Older Men. Psychosom Med. 2016;78(6):686-696. doi:10.1097/PSY.0000000000000312

10.       Besedovsky L, Lange T, Haack M. The Sleep-Immune Crosstalk in Health and Disease. Physiol Rev. 2019;99(3):1325-1380. doi:10.1152/physrev.00010.2018