Is tTG IgA useful for sleep?

The tTG IgA test (tissue transglutaminase antibodies) is a well-established screening tool for celiac disease. There is documented evidence linking untreated celiac disease to sleep disturbances, potentially through mechanisms such as malabsorption, systemic inflammation, or associated conditions like restless legs syndrome. However, tTG IgA is not a direct sleep biomarker. Its utility for sleep issues is limited to cases where celiac disease is clinically suspected (e.g., gastrointestinal symptoms, unexplained fatigue, iron deficiency anemia). In otherwise healthy individuals without risk factors, screening for celiac disease solely because of sleep complaints is not evidence-based. The evidence for benefit in isolated sleep problems is weak and indirect. False positives can occur, leading to unnecessary biopsies and anxiety. Therefore, tTG IgA is not recommended as a routine test for sleep assessment without a specific clinical indication for celiac disease.