Association between gastrointestinal disorders and sleep-related problems: the mediating effect of depression.

BACKGROUND: The relationship between gastrointestinal(GI) diseases and sleep-related problems—such as sleep trouble and sleep disorders—remains insufficiently understood. METHODS: Data were derived from the 2005–2014 U.S. National Health and Nutrition Examination Survey (NHANES). Multicollinearity was evaluated using variance inflation factors. Multivariable logistic regression and subgroup analyses were conducted to assess the association between GI diseases and sleep trouble. Mediation analyses explored whether depression mediated the relationships between GI diseases and sleep outcomes, including sleep trouble, sleep disorders, and sleep duration. Sensitivity analyses were performed to evaluate the robustness of the results.  RESULTS: In the context of fully adjusted models, individuals afflicted with gastrointestinal diseases exhibited an elevated propensity for experiencing sleep disturbances in comparison with those not affected by such conditions. (adjusted OR = 1.70, 95% CI: 1.41–2.05, P < .001). They also showed increased odds of sleep disorders (adjusted OR = 1.80, 95% CI: 1.34–2.41, P < .001) and a reduction in sleep duration (adjusted β = –0.15, 95% CI: –0.29 to –0.01, P = 0.038). These associations remained consistent across subgroups, including individuals without hypertension (adjusted OR = 1.69), without diabetes (adjusted OR = 1.72), with no smoking history (adjusted OR = 1.73), those with coronary artery disease (adjusted OR = 1.76), and those with higher DI-GM scores (adjusted OR = 1.81) (all P-values < .05). Mediation analysis indicated that depression partially mediated the associations between GI diseases and sleep trouble (Effect = 0.023, 95% CI: 0.022–0.035, P < .01), sleep disorders (Effect = 0.010, 95% CI: 0.008–0.014, P < .01), and sleep duration (Effect = –0.126, 95% CI: –0.248 to –0.050, P = 0.040). These mediation effects remained stable in sensitivity analyses. CONCLUSIONS: GI diseases are significantly associated with sleep disturbances, with depression serving as a partial mediator. These findings highlight the importance of addressing both gastrointestinal and psychological health in clinical efforts to improve sleep quality. Further research is needed to guide targeted interventions for this interconnected set of conditions.