Why does my gut feel worse after a bad night’s sleep?
Your gut doesn’t work in isolation. Here’s why sleep is one of the things I consider when exploring digestive symptoms…
You wake up after a terrible night's sleep and your gut already seems to know about it.
You're bloated. Your digestion feels different. Perhaps you're constipated, or things have gone rather the other way. You're unusually hungry, or you don't fancy breakfast at all. Foods you normally tolerate suddenly seem less appealing or appear to bother you more.
And if you're already struggling with digestive symptoms, it's very easy to start investigating the food.
What did I eat yesterday?
Was it the bread?
Did I eat too late?
Is it that new supplement?
Have I suddenly stopped tolerating something?
But there's another question I might ask in clinic:
How did you sleep?
Because your digestive system doesn't operate independently from the rest of you.
Your gut has a rhythm too
We often talk about circadian rhythm in relation to sleep, but our internal body clock influences processes throughout the body.
The gastrointestinal system also follows daily rhythms. Gut motility changes across the day and night, as do aspects of digestive function. Appetite and many of the hormones involved in its regulation are influenced by our sleep-wake and circadian rhythms.
Then there's the nervous system.
Your brain and gut are in constant two-way communication through what we commonly call the gut-brain axis. Stress, alertness, rest, sleep and digestion aren't isolated departments operating behind separate doors.
There is also growing research investigating relationships between circadian disruption, sleep and the gut microbiome.
Does that mean one rubbish night's sleep has damaged your microbiome or made your gut "leaky"?
No.
That's a much bigger claim than the evidence allows.
But poor or disrupted sleep can influence several of the physiological processes involved in how we eat, digest and experience our gut.
And if disrupted sleep is happening regularly, it becomes something I'm interested in.
Before you blame your dinner...
This is particularly important because digestive symptoms can make people frightened of food.
Something causes bloating or discomfort, so that food gets removed.
It happens again, and something else disappears.
Before long, someone can have an increasingly small list of foods they consider "safe".
Sometimes removing or modifying particular foods is clinically appropriate. But I don't want to unnecessarily restrict someone's diet when something else may be contributing to what they're experiencing.
That's why, when somebody tells me their gut has been particularly bad, I don't only want to know what they ate.
I want context.
How have you been sleeping?
What's happening with stress?
Has your routine changed?
Are you eating differently because you're tired?
Are you moving less?
Have your medications or supplements changed?
What's happening with your bowel movements?
Where are you hormonally and in your life stage (women and men)?
And importantly: is this a one-off, or is there a pattern?
Sometimes observation comes before intervention
We have an understandable tendency to want to do something when we experience symptoms.
Buy something.
Remove something.
Add a supplement.
Try another diet.
Book another test.
But sometimes one of the most useful things we can do initially is gather better information.
If you notice that your digestive symptoms seem worse after a poor night's sleep, spend some time observing what actually happens.
What happens to your bloating?
Do your bowel movements change?
Does your appetite change?
Do you experience more pain or discomfort?
Do particular foods genuinely become problematic, or does everything simply feel a little more difficult on those days?
And what happens after several nights of better sleep?
You're not trying to prove that sleep is "the cause".
You're looking for your pattern.
How I support this in nutritional therapy
This is one of the reasons my consultations cover considerably more than what's on your plate.
Of course I want to understand what you're eating. But I also want to know how you're eating, how you're digesting it and what else is happening around it.
We may look at meal timing and regularity, fibre and fluid intake, protein and overall nutrient adequacy, caffeine and alcohol, movement, medications and supplements, bowel habits, stress, sleep and your daily routine.
I may also look at existing blood results and medical history and, where appropriate, suggest that something needs discussing or investigating with your GP or another healthcare professional.
Sometimes functional testing can add useful information too, but I don't believe everyone with digestive symptoms automatically needs a test.
And sleep support isn't simply a case of telling someone to "get eight hours".
We might look at when you're sleeping, your exposure to daylight and darkness, evening habits, caffeine timing, meal timing, exercise, stress and the practical realities of your life.
Because there's little value in designing a supposedly perfect routine that you can't actually live with. Nor am I trying to optimise every minute of your day!
The aim is to identify the things that appear most relevant to you, decide which are worth working on and make changes that are realistic enough to continue.
The gut isn't always where the story starts, or ends
Digestive symptoms deserve to be taken seriously, particularly when they're persistent, worsening or accompanied by symptoms that require medical investigation.
But experiencing a digestive symptom doesn't automatically mean the answer lies in removing another food or taking another gut supplement.
Sometimes food matters enormously.
Sometimes sleep matters.
Sometimes stress, medication, hormones, bowel motility, medical history or something else entirely is contributing to the picture.
And very often, it's more than one thing.
So next time your gut seems particularly unhappy, by all means think about what you've eaten.
But perhaps ask yourself another question too:
What else was going on?
Because your gut is part of a whole person.
And that's the person I'm interested in understanding.