People with celiac disease have sleep problems unrelieved by gluten-free diets

As with many other autoimmune diseases, celiac disease can lead to problems with sleeping. Sleep disorders are common among those with celiac disease, according to research done in Italy several years ago. Why? It might appear that the condition’s symptoms prompt disruptions to sleep, but sleep disorders were found to persist even after all other symptoms of celiac disease were successfully treated in the patients in the study.

Why do people with celiac disease sleep poorly?

It might seem that the general chronic discomfort that people with celiac disease experience keeps them from getting quality sleep.

The symptoms of celiac

Many of its symptoms could be disruptive to sleep. These include the full range of gastrointestinal problems (such as gas, diarrhea, and constipation).

Even the symptoms of celiac which don’t pertain to the stomach could be assumed to have an association with poor sleep or sleep disorders, such as:

• Acid reflux and heartburn. Also known as gastroesophageal reflux disease (GERD), acid reflux occurs during both wake and sleep when the valve that prevents stomach acid from floating up into the esophagus loses its seal. When this happens, it leaks the stomach’s contents there. While sleeping, this acid may rise high enough to wash into the mouth. People who snore or have obstructive sleep apnea are at special risk for this. They could aspirate (breathe in) stomach acid into the lungs, causing serious damage to the bronchial tissues. and even leading to aspiration pneumonia.
• Anemia/iron deficiency. Low iron is famously related to restless legs syndrome (RLS). This sleep disorder condition is marked by distinctive discomfort and unpleasant sensation in the legs (usually) at the moment of rest. RLS ultimately causes sleep-onset insomnia in the sufferer, who must rise, move, and stretch their limbs to find relief.
• Anxiety and depression. According to Celiac.org, in children, “a wide range of mental health issues can arise for those with untreated celiac disease or non-celiac wheat sensitivity. Initially there may be a misdiagnosis of psychiatric illness due to some of the neurological and psychiatric symptoms that can be seen in untreated disease.” Having medical issues of any kind can often lead to problems with mental health. When this happens, one common outcome is a negative influence on sleep quality. Unfortunately, poor sleep tends to exacerbate anxiety and depression. This makes it hard for the person with celiac (or any other chronic illness) to enjoy a good quality of life.
• Fatigue. The problem of fatigue affects the vast majority of all people with autoimmune disorders. Fatigue leads to daytime sleepiness that often requires napping. While occasional short naps may be helpful, frequent long naps can create major circadian disruptions which lead to problems like sleep-onset insomnia and delayed sleep phase disorder.
• Headaches or joint pain. Pain of any kind can be one of sleep’s biggest enemies. People who go to bed with headaches or pain in their joints often struggle to fall asleep because of it. The analgesic medications they might take for relief could also interfere with sleep.

Sleep disorders as a primary symptom of celiac disease?

Remarkably, results published in a 2010 study at the University of Naples found that sleep disorders experienced by people diagnosed with, but not receiving treatment for, celiac disease were unrelated to GI distress.

Afterward, when restrictive dietary measures were taken to treat celiac disease in these subjects, their sleep problems did not improve. Meanwhile other symptoms of celiac were found to improve or disappear entirely.

In fact, for the study subjects, the sleep disorders they experienced were still not fully controlled after 6 years following a gluten-free diet. This, even though their digestive tracts were shown to improve and even heal during the same time.

The celiac-sleep connection

Ultimately, the takeway is this: People with celiac disease are far more likely to suffer from sleep disorders. Problems with sleep are now thought to be a primary symptom of the disease itself, rather than the result of symptoms. This makes disrupted sleep an important diagnostic marker for identifying and treating celiac disease.

It’s not known whether successful treatment of the sleep disorders that accompany celiac disease will result in improvements to the autoimmune condition.

But it’s worth a try. More and better sleep is always a goal for those suffering from chronic conditions, as the process of sleep allows the body to recharge and heal. With poor sleep, there’s less chance for either.

Sources:

“Celiac Disease Mental Health,” Celiac Disease Foundation (nd). Accessed from the internet on April 27, 2017.

“Celiac disease: Symptoms and causes,” Mayo Clinic (August 17, 2017). Accessed from the internet on April 27, 2017.

Zingone, F., Siniscalchi, M., Capone, P., Tortora, R., Andreozzi, P., Capone, E. and Ciacci, C. (2010). “The quality of sleep in patients with coeliac disease.” Alimentary Pharmacology & Therapeutics, 32: 1031–1036. doi:10.1111/j.1365-2036.2010.04432. Accessed from the internet on April 27, 2017.

“What is Celiac Disease?,” Celiac Disease Foundation (nd). Accessed from the internet on April 27, 2017.