Review
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World J Gastroenterol. Dec 28, 2013; 19(48): 9231-9239
Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9231
Sleep, immunity and inflammation in gastrointestinal disorders
Tauseef Ali, James Choe, Ahmed Awab, Theodore L Wagener, William C Orr
Tauseef Ali, Inflammatory Bowel Disease Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States
James Choe, William C Orr, Department of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, United States
Ahmed Awab, Department of Medicine, Section of Pulmonary and Critical Care, Oklahoma City, OK 73104, United States
Theodore L Wagener, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States
William C Orr, Lynn Health Science Institute, Oklahoma City, OK 73112, United States
Author contributions: The idea was proposed by Ali T; Ali T and Choe J drafted the initial manuscript; Awab A, Wagener TL and Orr WC reviewed and edited the draft; all authors approved the final manuscript before submission.
Correspondence to: Tauseef Ali, MD, Inflammatory Bowel Disease Center, University of Oklahoma Health Sciences Center, 920 SL Young Blvd. WP 1345, Oklahoma City, OK 73104, United States. tauseef-ali@ouhsc.edu
Telephone: +1-405-2715428 Fax: +1-405-2715803
Received: July 21, 2013
Revised: September 11, 2013
Accepted: September 29, 2013
Published online: December 28, 2013
Processing time: 177 Days and 19.9 Hours
Abstract

Sleep disorders have become a global issue, and discovering their causes and consequences are the focus of many research endeavors. An estimated 70 million Americans suffer from some form of sleep disorder. Certain sleep disorders have been shown to cause neurocognitive impairment such as decreased cognitive ability, slower response times and performance detriments. Recent research suggests that individuals with sleep abnormalities are also at greater risk of serious adverse health, economic consequences, and most importantly increased all-cause mortality. Several research studies support the associations among sleep, immune function and inflammation. Here, we review the current research linking sleep, immune function, and gastrointestinal diseases and discuss the interdependent relationship between sleep and these gastrointestinal disorders. Different physiologic processes including immune system and inflammatory cytokines help regulate the sleep. The inflammatory cytokines such as tumor necrosis factor, interleukin-1 (IL-1), and IL-6 have been shown to be a significant contributor of sleep disturbances. On the other hand, sleep disturbances such as sleep deprivation have been shown to up regulate these inflammatory cytokines. Alterations in these cytokine levels have been demonstrated in certain gastrointestinal diseases such as inflammatory bowel disease, gastro-esophageal reflux, liver disorders and colorectal cancer. In turn, abnormal sleep brought on by these diseases is shown to contribute to the severity of these same gastrointestinal diseases. Knowledge of these relationships will allow gastroenterologists a great opportunity to enhance the care of their patients.

Keywords: Sleep; Immune function; Immunity; Irritable bowel syndrome; Inflammatory bowel disease; Gastro-esophageal reflux disease; Liver disorders; Colon cancer; Circadian rhythm

Core tip: Sleep disorders have become a global issue, and discovering their causes and consequences are the focus of many research endeavors. Recent research suggests that individuals with sleep abnormalities are at greater risk of all-cause mortality and serious adverse health and economic consequences. Several studies support the associations among sleep, immune function and inflammation. We review the current research linking sleep, immune function, and gastrointestinal diseases and discuss the interdependent relationship between sleep, overall immune function with emphasis on inflammatory bowel disease, irritable bowel syndrome, gastro-esophageal reflux and colorectal cancer.