Prevalence of sleep disturbances in irritable bowel syndrome: a systematic review and meta-analysis

Abstract

Sleep disturbances are common comorbid conditions among patients with irritable bowel syndrome (IBS). This meta-analysis aimed to estimate the prevalence of sleep disturbances among patients with IBS and to quantify the association between IBS and sleep disturbances. PubMed, Embase, and Web of Science were systematically searched from database inception through June 2026 using terms related to functional gastrointestinal disorders, irritable bowel syndrome, insomnia, and sleep disturbances. Observational studies that reported sleep-disturbance data in patients with IBS and included a non-IBS control group were eligible. Random-effects models were used to pool the prevalence of sleep disturbances among patients with IBS and to estimate odds ratios (ORs) for the association between IBS and sleep disturbances. Heterogeneity was quantified using the I² statistic. Subgroup analyses were performed according to IBS diagnostic criteria, area, study population, sleep outcome type, publication year, and sleep measurement tool. Funnel plots, Egger’s regression test, and Begg’s rank correlation test were used to assess small-study effects and potential publication bias. Robustness was evaluated using leave-one-out and additional sensitivity analyses based on study design, methodological quality, and potential population overlap. A total of 5,477 records were identified, and 27 studies involving 400,932 participants were ultimately included, comprising 36,067 patients with IBS and 364,865 non-IBS controls. The pooled prevalence of sleep disturbances among patients with IBS was 33.32% (95% confidence interval [CI], 25.24%–42.52%). Compared with non-IBS controls, patients with IBS had significantly higher odds of sleep disturbances (OR, 2.55; 95% CI, 2.01–3.23). No statistically significant between-subgroup differences were observed in any of the six subgroup analyses (all P > 0.05). Neither Egger’s test ( P = 0.060) nor Begg’s test ( P = 0.869) indicated statistically significant publication bias. The pooled estimates remained materially unchanged after the exclusion of any single study. The direction of the association remained consistent in additional sensitivity analyses restricted to cross-sectional studies and higher-quality studies. Sleep disturbances are common among patients with IBS, and IBS is significantly associated with greater odds of sleep disturbances. However, substantial between-study heterogeneity and wide prediction intervals indicate that the magnitude of this association may vary considerably across study settings. High-quality longitudinal studies using standardized IBS diagnostic criteria and objective sleep measurements are needed to clarify the temporal relationship and underlying mechanisms. Given the observational and predominantly cross-sectional evidence base, these findings do not establish temporality or causality.

The authors' abstract, as published at the source. BMC Gastroenterology, 2026 · DOI ↗