People living with irritable bowel syndrome are far more likely than others to suffer from disturbed sleep, according to a new systematic review and meta-analysis published in BMC Gastroenterology. Pooling data from 27 observational studies, the analysis found that roughly one in three patients with IBS experiences sleep disturbances, and that having IBS is associated with more than double the odds of sleep problems compared with people without the condition.

The research team, led by Yan Fang, Shi-ping Sun and Han Min, searched PubMed, Embase and Web of Science from database inception through June 2026. Their screening of 5,477 records ultimately identified 27 studies encompassing 400,932 participants, of whom 36,067 had IBS and 364,865 served as non-IBS controls. Only observational studies that reported sleep-disturbance data in patients with IBS and included a non-IBS comparison group were eligible for inclusion.

Using random-effects models, the researchers calculated that the pooled prevalence of sleep disturbances among patients with IBS was 33.32 percent, with a 95 percent confidence interval ranging from 25.24 percent to 42.52 percent. The wide interval reflects considerable variation across the individual studies, a point the authors emphasise throughout their analysis.

When patients with IBS were compared directly with non-IBS controls, the odds of sleep disturbances were significantly higher in the IBS group, with an odds ratio of 2.55 and a 95 percent confidence interval of 2.01 to 3.23. In practical terms, this means that across the pooled studies, a diagnosis of IBS was associated with roughly two and a half times the odds of reporting disturbed sleep.

To probe whether the association differed across circumstances, the team carried out subgroup analyses according to IBS diagnostic criteria, geographic area, study population, type of sleep outcome, publication year and the sleep measurement tool used. No statistically significant between-subgroup differences emerged in any of the six subgroup analyses, with all P values exceeding 0.05.

The authors also examined whether smaller studies might be skewing the pooled results. Funnel plots, Egger’s regression test and Begg’s rank correlation test were used to assess small-study effects and potential publication bias. Neither Egger’s test, which returned a P value of 0.060, nor Begg’s test, with a P value of 0.869, indicated statistically significant publication bias.

Robustness was tested further through leave-one-out analyses and additional sensitivity analyses based on study design, methodological quality and potential population overlap. The pooled estimates remained materially unchanged after the exclusion of any single study, and the direction of the association stayed consistent in sensitivity analyses restricted to cross-sectional studies and to higher-quality studies.

Despite these reassuring consistency checks, the authors caution against overinterpreting the findings. Substantial between-study heterogeneity, quantified using the I² statistic, and wide prediction intervals indicate that the magnitude of the association between IBS and sleep disturbances may vary considerably across study settings. The evidence base is also predominantly cross-sectional and observational, which means the findings do not establish temporality or causality. In other words, the data cannot show whether sleep problems contribute to IBS symptoms, whether IBS drives sleep disruption, or whether both share other underlying causes.

Given these limitations, the authors call for high-quality longitudinal studies that use standardized IBS diagnostic criteria and objective sleep measurements. Such research, they argue, is needed to clarify the temporal relationship between the two conditions and to uncover the mechanisms that might connect them.

For clinicians and researchers, the pooled figures provide a benchmark: sleep disturbances are common among patients with IBS, and the association with IBS is statistically robust even after extensive sensitivity testing. But the authors’ own conclusion is measured. Sleep disturbances are common among patients with IBS, and IBS is significantly associated with greater odds of sleep disturbances, yet the magnitude of that association may vary considerably across settings, and only properly designed longitudinal studies can determine what the relationship actually means.

Subject of Research: The prevalence of sleep disturbances among patients with irritable bowel syndrome and the association between IBS and sleep disturbances

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

Article References: Fang, Y., Sun, S.-P., & Min, H. (2026). Prevalence of sleep disturbances in irritable bowel syndrome: a systematic review and meta-analysis. BMC Gastroenterology. https://doi.org/10.1186/s12876-026-05440-x

Image Credits: AI Generated

DOI: 10.1186/s12876-026-05440-x

Keywords: irritable bowel syndrome, sleep disturbances, meta-analysis, systematic review, prevalence, odds ratio, gastroenterology, observational studies, publication bias, heterogeneity, BMC Gastroenterology, sleep