Sleep, autonomic dysfunction and irritable bowel syndrome (IBS)

Before addressing specific data on sleep in IBS a general introduction to this disorder is appropriate; indeed it will readily become clear that many aspects of IBS provide a context in which sleep disturbance becomes likely and even inevitable. This discussion will focus on the connection between sleep fragmentation and the bidirectional communication pathway between the “big” brain in the cranium and the “little” brain in the gut that is considered central to our understanding of IBS. The associated pathophysiologic effects on intestinal permeability, immune activation, and neurohormal and neurosensory balance are discussed.