INTRODUCTION Sleep quality may affect symptom experience in irritable bowel syndrome (IBS). Our aim was to investigate the relationship between sleep quality and gastrointestinal (GI) symptoms using actigraphy and the experience sampling method. METHODS Patients with IBS were recruited from a tertiary Neurogastroenterology clinic and the community. GI symptoms and mood were recorded on a smartphone application, 10 times per day, over 7 consecutive days. Subjective sleep quality was recorded every morning to reflect the night before. Objective measures of sleep quality were estimated from wrist-worn actigraphy. Cross-lagged structural equation models were built to assess the directionality of sleep-symptom relationships over time. RESULTS Eighty patients with IBS completed the study (mean age: 37 years [range 20-68], 89% female, 78% community). Approximately 66% had a Pittsburgh Sleep Quality Index score ≥ 8, indicating a clinically significant sleep disturbance. Approximately 82% (95% CI: 72-90) screened positive for a sleep disorder, most commonly insomnia. In cross-lagged analysis, poor subjective sleep quality predicted next-day abdominal pain (0.036 < P < 0.040) and lower GI symptoms (0.030 < P < 0.032), but not vice versa. No significant relationship with GI symptoms was found for any objective sleep measure using actigraphy. DISCUSSION Poor subjective sleep quality was associated with higher next-day lower GI symptom levels, but not vice versa. Objective sleep measures did not predict next-day abdominal symptoms, potentially supporting the conclusion that it is the perception of sleep quality that is most influential. This study may be used to guide future research into the effect of sleep interventions on GI symptoms.

中文翻译：

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使用经验抽样方法，主观睡眠质量差可以预测肠易激综合症的症状。

简介 睡眠质量可能会影响肠易激综合征 (IBS) 的症状体验。我们的目的是使用体动记录仪和经验采样方法来研究睡眠质量与胃肠道 (GI) 症状之间的关系。方法 从三级神经胃肠病学诊所和社区招募 IBS 患者。胃肠道症状和情绪在智能手机应用程序上被记录，每天 10 次，连续 7 天。每天早上记录主观睡眠质量以反映前一天晚上的情况。睡眠质量的客观测量是通过腕戴式体动记录仪来评估的。建立交叉滞后结构方程模型来评估睡眠与症状关系随时间的方向性。结果 80 名 IBS 患者完成了研究（平均年龄：37 岁 [范围 20-68]，89% 为女性，78% 为社区）。大约 66% 的匹兹堡睡眠质量指数得分≥8，表明存在临床上显着的睡眠障碍。大约 82% (95% CI: 72-90) 的睡眠障碍筛查呈阳性，最常见的是失眠。在交叉滞后分析中，主观睡眠质量差可预测第二天的腹痛 (0.036 < P < 0.040) 和较低的胃肠道症状 (0.030 < P < 0.032)，但反之则不然。使用体动记录仪进行的任何客观睡眠测量均未发现与胃肠道症状存在显着关系。讨论 主观睡眠质量差与第二天较高的较低胃肠道症状水平相关，但反之则不然。客观睡眠测量并不能预测第二天的腹部症状，这可能支持这样的结论：对睡眠质量的感知影响最大。这项研究可用于指导未来关于睡眠干预对胃肠道症状影响的研究。