Wearable device study shows IBD inflammation reduces REM sleep and may predict disease flares

Mount Sinai researchers have published the first study to use wearable devices to assess how inflammation and symptoms in inflammatory bowel disease (IBD) affect sleep characteristics and sleep patterns over time.

The study found that significant changes in sleep metrics—specifically, reduced REM sleep and increased light sleep—only occurred when inflammation was present in the body, with symptoms alone not resulting in any notable sleep disruption. These findings, which further suggest that sleep changes signal upcoming disease flare episodes, were published in the journal Clinical Gastroenterology and Hepatology on June 26.

IBD is a disease category that includes ulcerative colitis and Crohn’s disease, and is characterized by inflammation in the digestive tract. Flare-ups, or increased disease activity, can include symptoms such as abdominal pain, diarrhea and bleeding. However, these symptoms can also occur in patients with IBD when no inflammation is present.

Poor sleep is a common complaint of patients with IBD. Previous research has relied mostly on short-term studies and subjective sleep assessments to evaluate impairments in sleep cycles, but it has been unclear whether sleep changes are due to symptoms, underlying inflammation, or both.

In this study, Mount Sinai researchers assessed sleep data from more than 100 participants with IBD who wore widely available wearable devices such as Apple Watches, Fitbits, and Oura Rings for an average of more than seven months. These data included sleep stages, percentage of time spent asleep while in bed, and total hours asleep. The team additionally collected daily symptom surveys and laboratory inflammation markers.

The researchers found that significant changes in sleep metrics, such as a decline in REM sleep—the phase of sleep that is considered deep and restorative—occurred only when inflammation was present in the body, with symptoms alone not resulting in any objective sleep disruption.

The team also performed longitudinal mapping of objective sleep patterns before, during, and after disease exacerbations using wearable technology. They analyzed sleep data for six weeks before and six weeks after flare episodes. The researchers found that sleep disturbances significantly worsen, leading up to inflammatory flares and improve afterward, suggesting that sleep changes may signal upcoming increased disease activity.

“This is the first study to longitudinally map objective sleep patterns before, during, and after IBD flares using wearable technologies—offering a new, noninvasive way to monitor disease activity and explore how poor sleep and inflammation are connected.

“Our findings are crucial because they suggest that poor sleep may be related to active inflammatory disease, even when patients are not reporting symptoms,” said corresponding author Robert Hirten, MD, Associate Professor of Medicine (Gastroenterology), and Artificial Intelligence and Human Health, at the Icahn School of Medicine at Mount Sinai. “This approach opens new possibilities for how wearable devices can monitor health events and track sleep in chronic diseases.”

The researchers said the study further conveys the ability to observe sleep continuously and passively using consumer-grade wearable devices, which may facilitate real-time disease monitoring in the future, as inflammation monitoring has traditionally required invasive or inconvenient testing such as bloodwork or stool samples.

Beyond IBD, the study shows the broader potential of wearable devices to capture subtle physiological changes linked to chronic diseases—a step forward in precision medicine and preventive care.

Mount Sinai researchers have published the first study to use wearable devices to assess how inflammation and symptoms in inflammatory bowel disease (IBD) affect sleep characteristics and sleep patterns over time.

The study found that significant changes in sleep metrics—specifically, reduced REM sleep and increased light sleep—only occurred when inflammation was present in the body, with symptoms alone not resulting in any notable sleep disruption. These findings, which further suggest that sleep changes signal upcoming disease flare episodes, were published in the journal Clinical Gastroenterology and Hepatology on June 26.

IBD is a disease category that includes ulcerative colitis and Crohn’s disease, and is characterized by inflammation in the digestive tract. Flare-ups, or increased disease activity, can include symptoms such as abdominal pain, diarrhea and bleeding. However, these symptoms can also occur in patients with IBD when no inflammation is present.

Poor sleep is a common complaint of patients with IBD. Previous research has relied mostly on short-term studies and subjective sleep assessments to evaluate impairments in sleep cycles, but it has been unclear whether sleep changes are due to symptoms, underlying inflammation, or both.

In this study, Mount Sinai researchers assessed sleep data from more than 100 participants with IBD who wore widely available wearable devices such as Apple Watches, Fitbits, and Oura Rings for an average of more than seven months. These data included sleep stages, percentage of time spent asleep while in bed, and total hours asleep. The team additionally collected daily symptom surveys and laboratory inflammation markers.

The researchers found that significant changes in sleep metrics, such as a decline in REM sleep—the phase of sleep that is considered deep and restorative—occurred only when inflammation was present in the body, with symptoms alone not resulting in any objective sleep disruption.

The team also performed longitudinal mapping of objective sleep patterns before, during, and after disease exacerbations using wearable technology. They analyzed sleep data for six weeks before and six weeks after flare episodes. The researchers found that sleep disturbances significantly worsen, leading up to inflammatory flares and improve afterward, suggesting that sleep changes may signal upcoming increased disease activity.

“This is the first study to longitudinally map objective sleep patterns before, during, and after IBD flares using wearable technologies—offering a new, noninvasive way to monitor disease activity and explore how poor sleep and inflammation are connected.

“Our findings are crucial because they suggest that poor sleep may be related to active inflammatory disease, even when patients are not reporting symptoms,” said corresponding author Robert Hirten, MD, Associate Professor of Medicine (Gastroenterology), and Artificial Intelligence and Human Health, at the Icahn School of Medicine at Mount Sinai. “This approach opens new possibilities for how wearable devices can monitor health events and track sleep in chronic diseases.”

The researchers said the study further conveys the ability to observe sleep continuously and passively using consumer-grade wearable devices, which may facilitate real-time disease monitoring in the future, as inflammation monitoring has traditionally required invasive or inconvenient testing such as bloodwork or stool samples.

Beyond IBD, the study shows the broader potential of wearable devices to capture subtle physiological changes linked to chronic diseases—a step forward in precision medicine and preventive care.