Do human body clocks and sleep play a role in IBD?
Research type
Research Study
Full title
Characterising chronotype, sleep and circadian disruption in inflammatory bowel disease
IRAS ID
293310
Contact name
John McLaughlin
Contact email
Sponsor organisation
Salford Royal NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of Research
Background
Inflammatory bowel disease (IBD) is an illness driven by a combination of genetic, environmental and immune-related factors, leading to intestinal inflammation characterised by abdominal pain, weight loss and bloody diarrhoea. Inflammation is known to disrupt the human body clock, or ‘circadian rhythm’. There is growing interest in the role of an individual’s circadian preference for ‘morningness’ or ‘eveningness’, termed chronotype, and the impact of disruption, for example through shift work, on the development of chronic inflammatory conditions such as IBD or arthritis. This is particularly important to investigate currently in light of the vital role key shift workers play in the COVID-19 pandemic. Circadian rhythms are also linked to diet, food intake and metabolism. These are closely interlinked components, which have never been studied together in IBD, but may hold important answers to improve patient management.
Objectives
- To assess the influence of chronotype on IBD
- To look at the influence of shift work, sleep patterns and food timing on IBD
- To address the impact of COVID-19 in IBD patients according to chronotype, its linkage to shift work, and on quality of life
Study design
An observational study taking place in the Northern Care Alliance: Salford Royal NHS Foundation Trust and Fairfield General Hospital in the Pennine Acute Hospitals NHS Trust.
Participants
- IBD patients in the Salford Royal and Fairfield gastroenterology clinics.
Study interventions and measures
- Individuals meeting eligibility criteria will be identified and provided with an information sheet by post.
- Those wishing to partake in the study will be given (via post/ email/online) consent forms and questionnaires to complete and return.
- Participants will complete a Munich Chronotype Questionnaire in addition to questionnaires on diet, shift work and impact on quality of life (QoL).
- Clinical details concerning their IBD will be recorded.Summary of Results
This study aims to investigate the relationship between inflammatory conditions and whether people tend to be morning (‘larks’) or evening people (‘owls’, so called chronotypes), exploring the influence of eating and sleeping patterns on prevalence and severity of symptoms. We have chosen inflammatory bowel disease (IBD), an umbrella term for ulcerative colitis (UC) and Crohn’s disease (CD). These conditions cause diarrhoea, abdominal pain and bleeding amongst other things.
Background: The 24-hour cycle, known as the circadian rhythm, is a built-in mechanism involved in the maintenance of vital body functions. Variations in these patterns displayed across the population, known as a chronotype, determines an individual’s preferences for the ‘sleep-wake cycle’. Recently, interest has developed on the association between the circadian mechanisms and the severity of symptoms in inflammatory conditions such as asthma, rheumatoid arthritis (RA), and IBD. Current research suggests such chronic condition may be linked to the oscillatory patterns observed in immune responses involved in their cause. This study aims to investigate the relationship between IBD and chronotypes, exploring the influence of eating and sleeping patterns on prevalence and severity of symptoms.
Methods: An observational prospective questionnaire study assessing chronotype and IBD severity using the well-recognised ‘Munich chronotype’ and ‘IBD-control’ questionnaires.
Key findings/conclusions: The morning chronotype was more common in participants with UC than CD with an earlier point of mid-sleep reported. IBD severity was significantly associated with sleep duration and quality. Mealtime had a significant influence on severity of IBD symptoms. Sleep duration and quality is impacted in individuals with IBD subtypes equally.
Future Plans: We are undertaking more research in the laboratory to understand the impact of these processes and underlying mechanisms in IBD which will form the basis of future grant application(s).
REC name
East of Scotland Research Ethics Service REC 2
REC reference
21/ES/0026
Date of REC Opinion
10 Mar 2021
REC opinion
Further Information Favourable Opinion