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What You Should Know: 

– Researchers at Mount Sinai have published a study, the first of its kind, to utilize wearable devices for assessing the intricate relationship between inflammation, symptoms, and sleep patterns in individuals with inflammatory bowel disease (IBD). 

– Published in Clinical Gastroenterology and Hepatology on June 26, the findings reveal that significant alterations in sleep, particularly reduced REM sleep and increased light sleep, are directly tied to the presence of inflammation, rather than symptoms alone, and may even signal impending disease flare-ups.

Unraveling the Mystery of IBD and Sleep

Inflammatory bowel disease, encompassing conditions like ulcerative colitis and Crohn’s disease, is characterized by chronic inflammation of the digestive tract. Patients frequently experience flare-ups, marked by symptoms such as abdominal pain, diarrhea, and bleeding. However, these symptoms can also manifest in the absence of inflammation, making it challenging to differentiate between symptomatic discomfort and active disease. Poor sleep is a pervasive complaint among IBD patients, but previous research has largely relied on short-term studies and subjective sleep assessments, leaving the precise drivers of sleep disruption unclear.

Wearable Technology: A New Lens on Sleep and Inflammation

To address this knowledge gap, Mount Sinai researchers embarked on a comprehensive study, leveraging the power of consumer-grade wearable devices. Over 100 IBD participants wore widely available devices like Apple Watches, Fitbits, and Oura Rings for an average of more than seven months. This provided a rich, continuous stream of objective sleep data, including sleep stages, sleep efficiency, and total sleep duration. Crucially, the research team also collected daily symptom surveys and objective laboratory inflammation markers.

The study’s most compelling discovery was that significant changes in sleep metrics, specifically a decline in REM sleep (the deep, restorative phase) and an increase in light sleep, occurred exclusively when inflammation was present in the body. Notably, symptoms alone did not lead to any objective sleep disruption.

Sleep as a Signal for Impending Flares

Beyond identifying the direct link between inflammation and sleep disturbances, the researchers performed a longitudinal analysis, mapping objective sleep patterns before, during, and after disease exacerbations. By analyzing sleep data for six weeks preceding and six weeks following flare episodes, they found a clear trend: sleep disturbances significantly worsened in the lead-up to inflammatory flares and subsequently improved. This critical finding strongly suggests that changes in sleep patterns could serve as an early warning signal for upcoming increases in disease activity.

“This is the first study to longitudinally map objective sleep patterns before, during, and after IBD flares using wearable technologies—offering a new, non-invasive way to monitor disease activity and explore how poor sleep and inflammation are connected,” stated Dr. Robert Hirten, MD, Associate Professor of Medicine (Gastroenterology), and Artificial Intelligence and Human Health, at the Icahn School of Medicine at Mount Sinai, and the corresponding author of the study. “Our findings are crucial because they suggest that poor sleep may be related to active inflammatory disease, even when patients are not reporting symptoms. This approach opens new possibilities for how wearable devices can monitor health events and track sleep in chronic diseases.”