Sleep disorders represent a diverse range of conditions that profoundly affect both individual well-being and societal healthcare expenditures (1). These conditions, which include sleep-disordered breathing, insomnia, narcolepsy, circadian rhythm disturbances, and restless legs syndrome, are prevalent in contemporary society. The connection between microbiota and the gut-brain axis (GBA) is characterized by a bidirectional relationship (3), enabling communication from the gut microbiota to the brain and from the brain back to the gut microbiota through various neurological, endocrine, immunological, and humoral channels.

A deficiency in sleep negatively influences the body's circadian rhythms and homeostatic processes, along with impairing cognitive abilities. Studies indicate that sleep plays a crucial role in shaping gut microbiota, where a lack of sleep leads to a decrease in microbiota diversity, which in turn interacts with the brain and impacts its operations (4,5,6).

While there is a wealth of literature addressing the effects of sleep on gut health and emotional there is a notable lack of data exploring the interrelationship among sleep and gut health The present research aims to assess the impact of sleep and gut health on healthy young volunteers.

AIM AND OBJECTIVES:

This study the impact of sleep on gut health and emotional well-being and to assess the impact of life style modifications on it. To study the impact of sleep on gut health and bowel patterns and relationship between sleep and gut disturbances.

A cross-sectional comparative study was carried out with 150 participants within the age range of 20 to 40 years, spanning two months at a tertiary care hospital. The study focused on individuals who reported a prior history of gastrointestinal conditions.

Individuals who have self-identified as having a history of gastrointestinal illnesses, severe liver diseases, and those who are on prescribed medications for these conditions, as well as individuals diagnosed with sleep and mental disorders and those receiving prescribed treatments for these issues. 

A well-structured, self-designed questionnaire was administered to all participants, which included sections on demographic details, medical history, sleep patterns, gut health status and sleep physiology, and various lifestyle questions.

TABLE 1: GI SYMPTOMS AND SLEEP PATTERN

TABLE 2: RELATIONSHIP BETWEEN SLEEP AND GUT CLEARANCE

TABLE 3: RELATIONSHIP BETWEEN SLEEP PATTERN, FIBRE INTAKE, TOBACCO, ALCOHOL AND EXERCISE

Disturbances in sleep patterns and sleep/wake cycles have been linked to various health outcomes, both in the short term, such as heightened stress responses and psychosocial challenges, and in the long term, including serious conditions like cardiovascular diseases and cancer (3). There are recent studies showing that the gut microbes through enteric nervous system plays a role in influencing brain functions. A lack of adequate sleep can disrupt hormonal balance, leading to an increase in cortisol, the stress hormone. Dr. Barish explains that elevated stress may contribute to issues with intestinal permeability, often termed leaky gut. This phenomenon permits the passage of food and toxins into the bloodstream, which can result in numerous complications, including bloating, inflammation, stomach pain, food sensitivities, and changes in the gut microbiome (7). Hormones that govern hunger can sometimes become dysregulated, causing an increase in appetite. Furthermore, when one is fatigued, there is a greater tendency to resort to unhealthy food options for a rapid energy boost. These choices can have detrimental effects on gut health and overall health. In a systematic review by Wennyo Camilo and associates, the impact of tobacco consumption on adult sleep quality was examined. The results demonstrated that smokers generally experience inferior sleep quality relative to their non-smoking counterparts. Nicotine, found in tobacco, is associated with the release of multiple neurotransmitters, including dopamine, which can interfere with normal sleep processes (8). The proper functioning of the biological clock is significantly influenced by both the timing and composition of meals. Moreover, there are notable differences between day and night regarding the composition, location, and activity of the gut microbiome, which is contingent upon the host's feeding patterns (9). Food that enters the gastrointestinal tract plays a crucial role in synchronizing the peripheral clocks found within it. Therefore, consuming meals during the late evening may lead to detrimental health effects, increasing the likelihood of serious issues such as hormonal imbalances, disruptions in circadian rhythms, and alterations in the gut microbiota (10). A postponement of the final meal by just one hour has been linked to elevated levels of C-reactive protein, insulin, glucose, and glycated haemoglobin, alongside a reduction in HDL cholesterol levels. Additionally, research indicates that earlier meal consumption correlates with enhanced weight loss outcomes. There is also evidence suggesting that time-restricted eating can lead to changes in gut microbiota. Limiting food intake to designated time frames has been found to increase beneficial bacteria such as Oscillibacter and Ruminococcaceae, while decreasing the populations of Lactobacillus and Lactococcus. (11,12).

The characteristics, quality, and origin of dietary intake significantly influence the gut microbiome, affecting both its composition and functionality. These factors also play a role in the interactions between the host and its microbiome. In diets typical of Western lifestyles, there is a significant shortfall in complex carbohydrates, which are essential sources of dietary fibre. This shortfall can lead to a permanent reduction in microbial diversity, resulting in the extinction of certain microbial species in the digestive tract. Notable features of this dietary pattern, such as higher levels of sugar and saturated fat consumption, coupled with lower dietary fibre intake, may contribute to the rising prevalence of chronic diseases, including type II diabetes, cancer, obesity, and inflammatory bowel disease (13). The intake of alcoholic beverages adversely affects the functionality of the gut microbiome. Alcohol consumption during pregnancy can have repercussions on the gut microbiota of new-borns. Specifically, among infants whose mothers consumed alcohol while pregnant, there has been a noted increase in the population of Megamonas, which may impact subsequent gut colonization. Both chronic and acute alcohol consumption can induce distinct alterations in the gut microbiome. Alcohol intake is associated with an increase in Actinobacteria and Proteobacteria, while it results in a reduction of Firmicutes. Furthermore, chronic alcohol consumption can lead to a decline in Bacteroidetes and an elevation in Proteobacteria, as well as detrimental changes to the intestinal barrier, including heightened intestinal permeability (14). The gut and brain are interconnected via the gut–microbiome–brain axis, with the gut microbiota affecting brain function through immunoregulatory, neuroendocrine, and vagus nerve pathways. Microorganisms that inhabit the human gut synthesize various metabolites, including neurotransmitters that influence the nervous system. This synthesis of metabolites occurs in cycles, playing an essential role in the regulation of the host's circadian rhythms and overall metabolism (15,16).

Sleep has impact on gut health of an individuals. People who were sleeping < 6 hours a day since long duration are having more GI issues like abdominal cramps, bloating, constipation, nausea, diarrhoea and loss of appetite were more in subjects who were sleeping for lesser duration.

1. C. Abad, C. Guilleminault.Diagnosis and treatment of sleep disorders: a brief review for clinicians Dialogues Clin Neurosci, 5 (2003), pp. 371-388.
2. M. Altevogt, Research I of M (US) C on SM and. Extent and health consequences of chronic sleep loss and sleep disorders. National Academies Press (US) (2006).
3. Kazemi R, Haidarimoghadam R, Motamedzadeh M, Golmohamadi R, Soltanian A, Zoghipaydar MR. Effects of Shift Work on Cognitive Performance, Sleep Quality, and Sleepiness among Petrochemical Control Room Operators. J Circadian Rhythms.2016; 14:1. Published 2016 Feb 3. doi:10.5334/jcr.134
4. Knutson KL, Phelan J, Paskow MJ, Roach A, Whiton K, Langer G, et al. The National Sleep Foundation's sleep health index. Sleep Health. 2017;3(4):234–40. 10.1016/j.sleh.2017.05.011 [DOI] [PubMed] [Google Scholar].
5. Maltz R.M., Keirsey J., Kim S.C., Mackos A.R., Gharaibeh R.Z., Moore C.C., Xu J., Somogyi A., Bailey M.T. Social stress affects colonic inflammation, the gut microbiome, and short-chain fatty acid levels and receptors. J. Pediatr. Gastroenterol.Nutr. 2019; 68:533–540. doi: 10.1097/MPG.0000000000002226.
6. van de Wouw M., Boehme M., Lyte J.M., Wiley N., Strain C., O’Sullivan O., Clarke G., Stanton C., Dinan T.G., Cryan J.F. Short-chain fatty acids: Microbial metabolites that alleviate stress-induced brain-gut axis alterations. J. Physiol. 2018; 596:4923–4944. doi: 10.1113/JP276431.
7. https://www.henryford.com/blog/2021/02/sleep-affects-gut-health.
8. Wennyo Camilo da Silva e Silva, Nathália Lima Costa, Douglas da Silva Rodrigues, Marianne Lucena da Silva, Katiane da Costa Cunha, Sleep quality of adult tobacco users: A systematic review of literature and meta-analysis, Sleep Epidemiology, Volume 2,2022,100028, ISSN 2667-3436, https://doi.org/10.1016/j.sleepe.2022.100028.
9. Thaiss C.A., Levy M., Korem T., Dohnalová L., Shapiro H., Jaitin D.A., David E., Winter D.R., Gury-BenAri M., Tatirovsky E., et al. Microbiota Diurnal Rhythmicity Programs Host Transcriptome Oscillations. Cell. 2016; 167:1495–1510.e12. doi: 10.1016/j.cell.2016.11.003. [DOI] [PubMed] [Google Scholar]
10. Xie Y., Tang Q., Chen G., Xie M., Yu S., Zhao J., Chen L. New Insights into the Circadian Rhythm and Its Related Diseases. Front. Physiol. 2019; 10:682. doi: 10.3389/fphys.2019.00682. [DOI] [PMC free article] [PubMed] [Google Scholar]
11. Wirth M.D., Zhao L., Turner-McGrievy G.M., Ortaglia A. Associations between Fasting Duration, Timing of First and Last Meal, and Cardiometabolic Endpoints in the National Health and Nutrition Examination Survey. Nutrients. 2021; 13:2686. doi: 10.3390/nu13082686. [DOI] [PMC free article] [PubMed] [Google Scholar]
12. Garaulet M., Gómez-Abellán P., Alburquerque-Béjar J.J., Lee Y.-C., Ordovás J.M., Scheer F.A.J.L. Timing of Food Intake Predicts Weight Loss Effectiveness. Int. J. Obes. 2013; 37:604–611. doi: 10.1038/ijo.2012.229. [DOI] [PMC free article] [PubMed] [Google Scholar]
13. Makki K., Deehan E.C., Walter J., Bäckhed F. The Impact of Dietary Fiber on Gut Microbiota in Host Health and Disease. Cell Host Microbe. 2018; 23:705–715. doi: 10.1016/j.chom.2018.05.012. [DOI] [PubMed] [Google Scholar]
14. Khoshbin K., Camilleri M. Effects of Dietary Components on Intestinal Permeability in Health and Disease. Am. J. Physiol. Gastrointestinal. Liver Physiol. 2020;319: G589–G608. doi: 10.1152/ajpgi.00245.2020. [DOI] [PMC free article] [PubMed] [Google Scholar]
15. Feng Q., Chen W.-D., Wang Y.-D. Gut Microbiota: An Integral Moderator in Health and Disease. Front. Microbiol. 2018;9:151. doi: 10.3389/fmicb.2018.00151. [DOI] [PMC free article] [PubMed] [Google Scholar]
16. Powley T.L., Wang X.-Y., Fox E.A., Phillips R.J., Liu L.W.C., Huizinga J.D. Ultrastructural Evidence for Communication between Intramuscular Vagal Mechanoreceptors and Interstitial Cells of Cajal in the Rat Fundus. Neurogastroenterol. Motil. 2008;20:69–79. doi: 10.1111/j.1365-2982.2007.00990.x. [DOI] [PubMed] [Google Scholar]