If you are not getting the recommended seven to eight hours of sleep each night you may be at an increased risk of developing ulcerative colitis according to a recent (2014) study in Clinical Gastroenterology and Hepatology.

Ulcerative colitis is a chronic autoimmune disease of the large intestine in which the gastrointestinal lining becomes inflamed and develops ulcers. This is caused by an abnormal response by the body's immune system. In patients with inflammatory bowel diseases the immune system mistakes food bacteria and other substances in the intestine for foreign or invading substances. Ulcerative colitis only affects the large intestine whereas Crohn's disease can affect any part of the GI tract. In addition ulcerative colitis only affects the lining of the colon which is in contrast to Crohn's where all layers of the intestinal wall can be affected.

"Both short and long durations of sleep have important health implications and are associated with increased overall mortality cardiovascular disease and cancer" said researcher Ashwin N. Ananthakrishnan MD MPH Massachusetts General Hospital. "Our findings indicate that ulcerative colitis may potentially be added to this list. We found that less than six hours of sleep per day and more than nine hours of sleep per day are each associated with an increased risk of ulcerative colitis."

For this research a prospective study was conducted of women who were enrolled in the Nurses' Health Study (NHS) I since 1976 and NHS II since 1989 and afterwards were followed using detailed biennial questionnaires. The study design the large size of the groups and the continued follow-ups allowed for a unique opportunity to examine the correlation between sleep duration and the incidence of disease.

The results showed a U-shaped relationship between sleep duration and the risk of ulcerative colitis with both short and long duration of sleep being associated with an increased risk of disease (independent of other known environmental risk factors).

In a previous study published in Clinical Gastroenterology and Hepatology (2013) researchers reported that poor sleep quality for Crohn's patients even while in remission resulted in a two fold increase in the risk of exacerbations of the condition at six months. All this data supports sleep disruption's impact on the immune system and it shows how essential it is that health care providers treating patients with GI and autoimmune diseases regularly inquire about the quality and duration of sleep.

Healthy Sleep Habits

It is important to go to sleep around the same time every night. When the timing of sleep is shifted even if the duration is the same sleep is not going to be as restorative. In addition watching TV and using computers before bed should be avoided. Computer screens (smartphones and laptops) emit light in the blue part of the spectrum. This does not seem to cause a problem during the daytime but at night this blue light limits the production of melatonin. As a result it disturbs the body's sleep-wake cycle. There are free apps available if someone really needs to be on the computer at night. These apps allow for colors to be adjusted in a way that reduces the stimulating effects of blue light at night.

Of course caffeine and other stimulants can keep a person up and interfere with sleep. Therefore it is best to avoid these four to six hours before bedtime. Same premise goes for working out. Exercising should be done earlier in the day as it increases cortisol and can make trying to fall asleep very difficult.

Environmental Triggers

In regards to autoimmune conditions health care practitioners should investigate environmental triggers. These can be food triggers such as food sensitivities or gluten (that can trigger inflammation) as well as anything coming in with the food such as toxins or molds. In addition a patient's nutrient status and their gut health (i.e. leaky gut disbiosis) are both important. Finally toxins such as heavy metals and xenobiotics as well as the total toxic burden in the body can affect the status of the immune system. What appears to happen with most autoimmune conditions is that there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and our immune system gets into an overloaded overwhelmed state and ultimately loses its ability to function.

by Michael Jurgelewicz DC DACBN DCBCN

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