Published in:
01-12-2019 | Irritable Bowel Syndrome | Gastroenterology for Geriatric Patients (S Katz and A Afzali, Section Editors)
Sleep Disturbances in the Elderly Patient with Inflammatory Bowel Disease
Published in: Current Treatment Options in Gastroenterology | Issue 4/2019
Login to get accessAbstract
Purpose of review
Studies have suggested that sleep and inflammatory bowel disease (IBD) appear to have an important bi-directional relationship, where active disease promotes sleep disruption and poor sleep promotes ongoing and worsening inflammation. In the geriatric population, poor sleep has been linked to increasing morbidity and mortality. The etiologies of poor sleep in the elderly are multifactorial and are understood to be a part of the geriatric syndromes, conditions in the elderly associated with poorer mortality and morbidity. We review the current literature regarding the common sources of sleep disturbances in the geriatric population and, by extension, the growing population of elderly patients with IBD.
Recent findings
There is a high prevalence of sleep dysfunction in patients with inflammatory bowel disease, not only in patients in disease remission but also in patients with active disease. Poor sleep has been suggested a potential marker of ongoing subclinical inflammation, and sleep disturbances are linked to poorer outcomes in patients with IBD. Management of inflammation appears to improve fatigue symptoms but is not linked with the elimination of symptoms. Thus, alternative etiologies of poor sleep, especially in the geriatric population, include chronic medical conditions with polypharmacy, co-morbid mood disorders, and primary disorders of sleep.
Summary
Sleep disturbances in the elderly patient with IBD are related to multiple etiologies. Poor sleep is linked to both worse disease–specific outcomes and higher morbidity and mortality. Coordination of care with geriatricians, mental health professionals, and sleep specialists is often required to target the appropriate cause. We provide an etiological framework in the assessment of poor sleep in the elderly patient with IBD.