Original Article

Relationship between Neuroticism and Gastrointestinal Symptoms in Irritable Bowel Syndrome: The Mediating Role of Sleep


Background: We aimed to explore the relationship between the sleep and gastrointestinal symptoms in patients with irritable bowel syndrome (IBS) from the perspective of personality factors.

Methods: Overall, 167 patients with IBS-– from First Affiliated Hospital of Nanjing Medical University in Jiangsu Province of China in 2019 were included. Gastrointestinal Symptom Score (GIS), Chinese version of Pittsburgh Sleep Quality Index (PSQI) and Eysenck Personality Questionnaire (EPQ) were used to assess gastrointestinal symptoms, sleep and personality. We use mediator variables analyze to explore the relationship between sleep, neurotic personality and gastrointestinal symptoms in IBS patients.

Results: 48.5% of IBS patients had sleep disorders. IBS patients with high neuroticism had higher total PSQI scores, longer sleep latency, worse sleep persistence, more nocturnal sleep disturbances and daytime dysfunctions, and more use of sleep medication (P<0.05). Stomach distention, cramping epigastric pain, loss of appetite, and epigastric pain were more prominent in IBS patients with high neuroticism (P<0.05). In addition, neurotic personality was significantly predictive of sleep and some gastrointestinal symptoms, and sleep was a complete mediator of neurotic personality and gastrointestinal symptoms in IBS patients.

Conclusion: High neurotic personality in IBS patients leads to more prominent gastrointestinal symptoms by causing sleep disturbance.

1. Lacy BE, Mearin F, Chang L, et al (2016). Bowel Disorders. Gastroenterology, 150(6):1393-1407.
2. Black CJ, Ford AC (2020). Global burden of irritable bowel syndrome: trends, predic-tions and risk factors. Nat Rev Gastroenter-ol Hepatol, 17(8):473-486.
3. Ford AC, Sperber AD, Corsetti M, et al (2020). Irritable bowel syndrome. Lancet, 396(10263):1675-1688.
4. Orr WC, Fass R, Sundaram SS, et al (2020). The effect of sleep on gastrointestinal functioning in common digestive diseas-es. Lancet Gastroenterol Hepatol, 5(6):616-624.
5. Patel A, Hasak S, Cassell B, et al (2016). Ef-fects of disturbed sleep on gastrointesti-nal and somatic pain symptoms in irrita-ble bowel syndrome. Aliment Pharmacol Ther, 44(3):246-258.
6. Tu Q, Heitkemper MM, Jarrett ME, et al (2017). Sleep disturbances in irritable bowel syndrome: a systematic review. Neurogastroenterol Motil, 29(3).
7. Goldsmith G, Levin JS (1993). Effect of sleep quality on symptoms of irritable bowel syndrome. Dig Dis Sci, 38(10):1809-1814.
8. Buchanan DT, Cain K, Heitkemper M, et al (2014). Sleep measures predict next-day symptoms in women with irritable bowel syndrome. J Clin Sleep Med, 10(9):1003-1009.
9. Koloski NA, Jones M, Walker MM, et al (2021). Sleep disturbances in the irritable bowel syndrome and functional dyspep-sia are independent of psychological dis-tress: a population-based study of 1322 Australians. Aliment Pharmacol Ther, 54(5):627-636.
10. Laar M, Verbeek I, Pevernagie D, et al (2010). The role of personality traits in in-somnia. Sleep Medicine Reviews, 14(1):61-68.
11. Dbek-Drobny A, Mach T, Zwolińska-Wciso M (2020). Effect of selected personality traits and stress on symptoms of irritable bowel syndrome. Folia Medica Cracoviensia, 60(2):29-41.
12. Adam B, Liebregts T, Saadat-Gilani K, et al (2005). Validation of the gastrointestinal symptom score for the assessment of symptoms in patients with functional dyspepsia. Aliment Pharmacol Ther, 22(4):357–363.
13. Liu X, Tang M (1996). Reliability and validity of Pittsburgh sleep quality index. Chinese Journal of Psychiatry, 29(2):5. (In Chinese)
14. Gong Y (1993). Eysenck personality Question-naire. Changsha: Hunan Medical Press. (In Chinese)
15. Wu JP, Song Z Y, Xu Y, et al (2010). Probe into sleep quality in the patients with irri-table bowel syndrome. Zhonghua Nei Ke Za Zhi, 49(7):587-90.
16. Gadinger MC, Fischer JE, Schneider S, et al (2009). Female executives are particularly prone to the sleep-disturbing effect of isolated high-strain jobs: a cross- section-al study in German-speaking executives. J Sleep Res, 18:229-237.
17. Chen L, Xia L, Ha L, et al (2013). Personali-ty characteristics and mental health fac-tors of irritable bowel syndrome. Chinese Journal of Health Psychology, 08:1165-1167. (In Chinese)
18. Steinsvik EK, Valeur J, Hausken T, et al (2020). Postprandial Symptoms in Pa-tients with Functional Dyspepsia and Irri-table Bowel Syndrome: Relations to Ul-trasound Measurements and Psychologi-cal Factors. J Neurogastroenterol Motil, 26(1):96-105.
19. Stephan Y, Sutin A R, Bayard S, et al (2018). Personality and sleep quality: evidence from four prospective studies. Health Psy-chol, 37(3):271-281.
20. Sperber AD, Tarasiuk A (2007). Disrupted sleep in patients with IBS--a wake-up call for further research? Nat Clin Pract Gas- troenterol Hepatol, 4:412-413.
21. Bellini M, Gemignani A, Gambaccini D, et al (2011). Evaluation of latent links between irritable bowel syndrome and sleep quali-ty. World J Gastroenterol, 17(46):5089-96.
22. Liu Q (2018). The relationship between neu-roticism and sleep quality before test and irritable bowel syndrome in adolescents. Jiangxi Normal University. (In Chinese)
23. Furukawa Y, Cook IJ, Panagopoulos V, et al (1994). Relationship between sleep pat-terns and human colonic motor patterns. Gastroenterology, 107(5):1372-1381.
24. Fass R, Fullerton S, Tung S, et al (2000). Sleep disturbances in clinic patients with functional bowel disorders. Am J Gastro-enterol, 95(5): 1195-2000.
25. Besedovsky L, Lange T, Born J (2012). Sleep and immune function. Pflugers Arch, 463(1):121-137.
26. Song GH, Leng PH, Gwee KA, et al (2005). Melatonin improves abdominal pain in irritable bowel syndrome patients who have sleep disturbances: a randomized, double blind, placebo controlled study. Gut, 54(10): 1402-1407.
IssueVol 51 No 9 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v51i9.10554
Irritable bowel syndrome Neuroticism Gastrointestinal symptom Sleep Mediation effect

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How to Cite
Cong X, Li Y, Bian R. Relationship between Neuroticism and Gastrointestinal Symptoms in Irritable Bowel Syndrome: The Mediating Role of Sleep. Iran J Public Health. 2022;51(9):1999-2006.