How IBS Can Disrupt Your Sleep, Plus Tips to Get a Better Night’s Rest

A complex communication system called the gut-brain axis connects your brain and gastrointestinal tract, or gut. This connection means gut disturbances can disrupt the parts of your nervous system that control sleep. A lack of sleep, meanwhile, can worsen IBS symptoms.

Experts have several theories on how IBS and sleep disturbances influence each other. Many of these issues overlap.

Pain

It can be hard to relax enough to drift off when you feel like someone has a vice grip on your small intestine, as some people might describe their IBS symptoms.

A 2018 survey of Dutch university students linked IBS pain to:

• taking longer to fall asleep
• perceived sleep quality
• more nighttime awakenings

Constipation and diarrhea symptoms also affected these sleep variables. However, pain was by far the most influential factor. None of the IBS symptoms affected total sleep time.

On the other hand, poor sleep may also cause IBS pain. A small 2014 study involving 24 women found they were more likely to have abdominal IBS pain if they reported poor sleep the night before.

Typically, when your intestinal muscles move during digestion, your body knows that movement, called peristalsis, is safe and normal.

But sleep-deprived nerves can “forget” that fact and perceive peristalsis as dangerous spasms. They then send pain signals to your brain to alert you, causing shoots of pain as food moves through your gut.

Dysbiosis

Your intestines don’t just hold stool. They also contain your microbiome, a complex ecosystem of microbes that help your body break down food for digestion.

Disruptions to this ecosystem, called dysbiosis, can interfere with your bowel functioning. Nearly 3 in 4 people with IBS have dysbiosis, estimates 2015 research.

Animal research suggests that when your microbiome doesn’t correctly break down food, the leftover chemicals can interfere with your circadian rhythm. If your body’s internal clock is thrown off, you may have trouble falling or staying asleep.

Chronic sleep issues can also disrupt your microbiome and contribute to IBS symptoms. Getting enough sleep, on the other hand, can restore balance to the community of bacteria in your gut.

Autonomic system

People with IBS tend to have more inflammatory agents, such as tumor necrosis factor α (TNFα), in their gut. TNFα can inhibit the internal clock that tells organs what to do when. This may throw off your sleep schedule.

The reverse pattern is also possible. Sleep disturbances often raise your inflammation levels. Inflammation, in turn, can cause cramping, diarrhea, and constipation.

In many cases, the sleep disturbances found in IBS involve symptoms severe and persistent enough to qualify as clinical sleep disorders.

Researchers in a 2018 review analyzed 36 IBS studies with more than 63,000 total study participants.

According to the results, 37.6% of people with IBS also have a sleep disorder. If you have IBS, you are over twice as likely to have a sleep disorder than someone without the condition. Sleep disorders are seven times more frequent among children and adolescents with IBS than the general public.

The 2018 review didn’t cover specific diagnoses, though. But a smaller 2021 survey of U.S. adults examined how often certain sleep issues appeared with IBS. After controlling for demographic variables, researchers found people with IBS were:

• 3.1 times as likely to have symptoms of insomnia
• 4.6 times as likely to have symptoms of hypersomnia (excessive sleepiness)
• 5 times as likely to have symptoms of both insomnia and hypersomnia

Other conditions can also contribute to sleep issues, even if you also have IBS. As a matter of fact, this condition often occurs alongside other concerns that tend to affect sleep.

Chronic pain

According to the 2021 survey mentioned above, 63% of people with IBS have chronic back or neck pain — in addition to any bowel pain they have from IBS.

Pain can activate your sympathetic nervous system, which tells your body to stay alert and prepare to act. Your body may divert resources from the parts of your brain in charge of sleep, which makes your sleep less restful. Severe pain may even wake you up from sleep.

Mood disorders

That 2021 survey also found that more than 1 in 4 people with IBS live with a mood disorder, including depression and bipolar disorder.

Mood disorders, also called affective disorders, can affect how your brain moves through the phases of sleep, especially REM sleep. This is why sleep issues are among the main criteria for these mental health conditions.

In fact, over 90% of people with depression experience some kind of sleep disturbance, according to a 2019 review. People living with bipolar disorder also commonly report sleep problems.

Anxiety

Around 37% of people with IBS also have an anxiety condition.

People living with anxiety often have higher levels of the stress hormone cortisol in their bodies. This hormone also helps you wake up in the morning.

But high nighttime levels of cortisol can make it hard to fall asleep, which helps explain why anxiety and insomnia often come hand in hand.

It’s possible to improve both your sleep and IBS symptoms at home with some lifestyle changes. You can try these strategies right away:

Move your body

Physical movement can help you blow off steam, which can leave you less restless at night. Exercise can also help reinforce your circadian rhythm.

You don’t have to run a marathon to wear yourself out, though. Gentle exercise like yoga or walking can improve your sleep.

A 2019 review suggests aerobic exercise may help improve IBS-related constipation, but many of the included studies had a low quality of evidence.

What’s more, exercise therapy may not work for everyone. If you experience bowel pain while working up a sweat, you may want to opt for gentler forms of exercise.

Cut back on caffeine before bed

Caffeine is a stimulant that can stay in your system for several hours. If you drink coffee or an energy drink within 6 hours of your bedtime, you may still feel wired when your head hits the pillow.

Caffeine can also rile up your intestines and may cause diarrhea, which can also keep you awake.

A 2021 study involving 3,362 Iranian adults linked drinking coffee at least once a week to a higher chance of developing IBS. People who consumed more than 106.5 milligrams (mg) of caffeine a day had a 47% greater chance of developing IBS symptoms than those who consumed less caffeine.

For reference, an 8-ounce cup of brewed coffee contains about 95 mg of caffeine on average.

Fill up on fiber

A national survey of more than 5,500 U.S. adults linked fiber intake to sleep duration.

Adults who reported “very short” sleep, or fewer than 5 hours, ate an average of 13.2 grams (g) of fiber per day. Meanwhile, adults who reported a “normal” amount of sleep, or 7 to 8 hours, ate 16.6 g of fiber per day.

Fiber can also help improve constipation symptoms in IBS, since soluble fiber can help stool move more quickly and easily through your intestines.

Common sources of soluble fiber include:

• Beans: black beans, lima beans, kidney beans
• Vegetables: broccoli, carrots, Brussels sprouts
• Fruits: pears, apricots, apples
• Nuts and seeds: hazelnuts, sunflower seeds, flax seeds
• Grains: oats, barley

Consider melatonin supplements

Your body produces the hormone melatonin to signal when it’s time to sleep. Some people take melatonin supplements to treat insomnia.

Research from 2014 suggests 3 mg of melatonin at bedtime may help improve abdominal pain related to IBS. Scientists theorize that melatonin affects your intestinal functioning by:

• making sure stool moves at an even pace, rather than too fast or too slow
• reducing inflammation in your colon
• dampening pain signals from excitable nerves in the gut

While melatonin supplements are generally safe, they can interact with other drugs, so it’s always best to ask a healthcare professional before adding melatonin supplements to your diet.

If your IBS symptoms don’t improve with lifestyle changes, or if they begin to affect your overall quality of life, you may want to visit a gastroenterologist. Getting treatment for your IBS symptoms may improve sleep and gastrointestinal issues.

Treatment typically involves a combination of dietary changes and medication. The specifics of your treatment plan may vary based on the subtype of IBS you have:

• constipation subtype (IBS-C)
• diarrhea subtype (IBS-D)
• mixed subtype (IBS-M)

Dietary changes

Many people with IBS find the food they eat directly affects their symptoms. Any IBS treatment will most likely include a dietary component.

A survey of 1,562 U.S. gastroenterologists asked them which specialty diets they recommended in their practice:

• 77% recommended a low FODMAP diet
• 45% recommended a high fiber diet
• 45% recommended a reduced lactose diet
• 18% recommended a low fat diet
• 12% recommended a gluten-free diet

In some cases, your doctor may refer you to a registered dietitian to build a personalized nutrition plan.

The power of peppermint

Some evidence suggests peppermint supplements can also relieve IBS symptoms. Just keep in mind that supplements, or peppermint oil capsules in specific formulations, pack a lot more punch than a cup of peppermint tea.

While tea can certainly help soothe an upset stomach, you’ll generally want to opt for supplements over tea to help ease IBS symptoms. A doctor or other healthcare professional can offer more guidance on trying peppermint supplements.

Medication

While over-the-counter (OTC) medications can help with occasional constipation or diarrhea, persistent IBS symptoms may require stronger medications.

Your doctor may prescribe:

• antispasmodics, which relieve muscle spasms in your gut
• laxatives or stool softeners, which make it easier to pass stool
• antidiarrheal agents, which help slow down the contractions in your intestines, making stool firmer

Antidepressants

It may surprise you to learn antidepressants can also make up part of IBS treatment.

Antidepressants can lower inflammation and stress, which contribute to IBS pain. They can also affect bowel function.

Tricyclic antidepressants (TCAs), an older class of antidepressants, can slow digestion and reduce diarrhea.

If you have constipation, your IBS care team might recommend the newer selective serotonin reuptake inhibitors (SSRIs). They can speed up your digestion, improving constipation.

In addition, antidepressants can indirectly improve sleep issues that relate to underlying anxiety or depression, whether these concerns relate to IBS symptoms or another cause.

Gut health and sleep have a two-way relationship: Issues with one bodily function can cause problems with the other.

To sum up, IBS can disturb your sleep, and that disruption can worsen your IBS symptoms, creating a negative feedback loop.

Here’s the good news: The healing process also has a bidirectional effect. Improving your sleep can reduce IBS symptoms. Likewise, treating IBS can help you sleep better.

If IBS has interrupted your nightly rest, a good next step involves reaching out to a doctor or other healthcare professional. They can help you build a holistic treatment plan that addresses all your health needs.

Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.