Prevalence of Obstructive Sleep Apnea Is Increased in Patients With Inflammatory Bowel Disease: A Large, Multi-Network Study

If you live with inflammatory bowel disease (IBD), you are probably no stranger to sleep disruption. The pain caused by Crohn’s disease or ulcerative colitis is enough to upend patients’ sleep schedules, let alone bowel urgency, fatigue during the daytime, and a multitude of other symptoms that can impact sleep.

A new study published in Crohn’s & Colitis 360 indicates that there is an additional concern that is not often talked about when it comes to sleep and IBD: diagnoses of Crohn’s disease or ulcerative colitis were associated with higher rates of obstructive sleep apnea (OSA).

OSA is a breathing disorder that causes airflow to intermittently stop during sleep. Persistent inflammation of the airway is a known mechanism for developing OSA, and prior research has found a link between IBD and inflammation in the body outside of the intestines, including in the airway. With this knowledge, researchers sought to understand whether IBD patients are at an increased risk for developing OSA.

Using a database with patient data from 2015 to 2020, researchers analyzed the records of 117,510 people diagnosed with ulcerative colitis, 145,590 people with Crohn’s disease, and 40,707,320 people who did not have IBD. Before adjusting confounding factors, researchers found that 4.3% of people without IBD had OSA, while 7.8% of ulcerative colitis patients and 7.2% of Crohn’s disease patients had OSA.

After discovering this statistically significant difference between IBD patients and the general population, researchers addressed other known risk factors for OSA that could confound the initial findings. After adjusting the results to control for other OSA risk factors like obesity, tobacco use, high blood pressure, and diabetes, IBD remained an independent risk factor for developing OSA.

The increased prevalence of OSA among IBD patients is consistent with a previous study of patients with rheumatoid arthritis (RA) that found patients with RA were more likely to be considered “high risk” for OSA than the general population. Researchers theorize that when people with inflammatory diseases experience systemic inflammation, their risk for developing OSA increases.

The researchers note that in addition to being independently associated with OSA, IBD is an independent risk factor for cardiovascular disease, though it is currently unconfirmed if having both IBD and OSA have compounding negative cardiovascular effects. 

The researchers recommend that IBD patients be screened for OSA, especially if a patient has at least one other risk factor for developing OSA. Screening for OSA may involve a healthcare professional recording your body mass index (BMI) and blood pressure, and answering questions about tiredness, snoring, and breathing issues.  Diagnostic testing for OSA may include a polysomnogram – a sleep study in which a patient’s heart, lung, and brain activity are monitored.

If you have questions about OSA and IBD, our IBD Help Center is available to assist you. To contact our IBD Help Center, email [email protected] or call 1-888-MYGUTPAIN. Chat with a live specialist available Monday, Tuesday and Thursday from 9 a.m. to 5 p.m. ET.