Gut Microbiome, Irritable Bowel Syndrome and Obstructive Sleep Apnea: An Overview on this Interaction

Keywords

sleep - sleep disorders - obstructive sleep apnea - gut microbiome - irritable bowel syndrome

Introduction: Sleep disorders, including obstructive sleep apnea (OSA), may play a role in gastrointestinal disturbance and dysmotility, affecting the microbiome and gut hormonal regulation. Irritable bowel syndrome (IBS) is a condition that affects the large intestine, in the absence of any organic reasons.

Aim: This analysis aimed to describe and evaluate updates on this triple relationship (OSA, IBS and gut microbiome), which may guide future directions to this research line.

Methods: A search strategy was adopted and a literature review was performed through the electronic database PubMed. Review articles that linked directly or parallelly this association were included in this narrative analysis. Combined terms were used including “and” to refine the search. The term “sleep apnea and gut microbiome” produced 7 articles, and “sleep apnea and irritable bowel syndrome” 1 article. From the term “irritable bowel syndrome and gut microbiota,” a total of 15 of the most recent articles (past 5 years) was considered worthy to support our work.

Results: The IBS may be associated with dysbiosis and signaling imbalance of the gut-brain axis. This axis is a bidirectional link between the endocrine, immune and autonomic neural systems, which classically influence bowel motility and the gut microbiota. Several substrates, including cholecystokinin, vasoactive intestinal peptide, substance P and neuropeptide Y, contribute to the physiological regulation of the bowel tract. The altered gut microbiota may suffer influence of gut peptides, and lead to gastrointestinal disruption. As these substrates may be mediated by immune and neuroendocrinological pathways, and may regulate brain-gut neurotransmission, the role of sleep should be emphasized in this interaction, including the possible involvement of OSA in gut microbiota changes. Poor sleep resulting from OSA may dysregulate the gut-brain axis, which can impair the individual's microbiome and increase IBS severity. Substance P (related with pain and higher sensibility) may influence the hypoxia in OSA, and altered levels of this peptide were described in cases of excessive daytime sleepiness in OSA.

Conclusions: Further experimental and clinical studies could provide better understanding of the relationship between IBS and OSA, and sleep in general; and help to promote better management of any disturbance to the gut microbiome and bowel regulation.

Funding:

AFIP, CAPES and CNPq.

 

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Publikationsverlauf

Artikel online veröffentlicht:
15. Juni 2023