Background: We aimed to investigate the prospective association of individual and combined sleep behaviors and mental health (psychological distress and neuroticism) with incident irritable bowel syndrome (IBS).
Methods: A total of 302,839 participants without prior IBS in the UK Biobank were enrolled. A healthy sleep score was created according to five sleep factors and defined the low-risk groups as follows: sleep 7-8 h/day, early chronotype, never/rarely insomnia, no snoring, and no frequent excessive daytime sleepiness. Psychological distress and neuroticism were ascertained using the Patient Health Questionnaire and the Eysenck Personality Questionnaire-Revised Short Form, respectively. The primary outcome was incident IBS, based on self-report or linkage to death register and/or primary care and/or hospital admission data.
Results: During a median follow-up of 12.0 years, 5574 participants developed IBS. Overall, low-risk sleep behaviors and a healthy sleep score (per one point increment, HR, 0.81, 95%CI, 0.79-0.83) were associated with a lower risk of incident IBS, 29.4 %-32.4 % of which was mediated by mental health. Psychological distress (per one point increment, HR, 1.16, 95%CI, 1.14-1.17) and neuroticism (HR, 1.11, 95%CI, 1.10-1.12) were positively associated with incident IBS, and healthy sleep scores mediated 8.3 %-9.7 % of the association. Moreover, participants with lowest healthy sleep score/highest mental health score and higher genetic risk of IBS showed the highest risk of incident IBS.
Limitations: Sleep behaviors and mental health were assessed by self-reported questionnaires.
Conclusions: Healthy sleep scores and low psychological distress/neuroticism were associated with a lower risk of IBS, regardless of genetic predisposition.
Keywords: Genetic susceptibility; Irritable bowel syndrome; Mental health; Sleep behaviors.
Copyright © 2023. Published by Elsevier B.V.