Gastroesophageal Reflux Disease and Sleep Quality in a Chinese Population

• Published in: Journal of the Formosan Medical Association Vol. 108; no. 1; pp. 53 - 60
• Main Authors: Chen, Mei-Jyh, Wu, Ming-Shiang, Lin, Jaw-Town, Chang, Kuang-Yi, Chiu, Han-Mo, Liao, Wei-Chih, Chen, Chien-Chuan, Lai, Yo-Ping, Wang, Hsiu-Po, Lee, Yi-Chia
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 2009; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Body Mass Index; China - epidemiology; Cross-Sectional Studies; endoscopy; Esophagitis - classification; Esophagitis - complications; Esophagitis - pathology; Esophagoscopy - adverse effects; Female; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - epidemiology; Gastroesophageal Reflux - pathology; gastroesophageal reflux disease; Humans; Internal Medicine; Logistic Models; Male; Middle Aged; Polysomnography - adverse effects; Risk Factors; sleep; Sleep Wake Disorders - epidemiology; Sleep Wake Disorders - physiopathology; Surveys and Questionnaires; Treatment Outcome; China; sleep; endoscopy; gastroesophageal reflux disease
• ISSN: 0929-6646
• DOI: 10.1016/S0929-6646(09)60032-2

Background/Purpose Although evidence suggests that gastroesophageal reflux disease (GERD) may interrupt sleep, the effects of symptomatic and endoscopically diagnosed GERD remain elusive because the patient population is heterogeneous. Accordingly, we designed a cross-sectional study to assess their association. Methods Consecutive participants in a routine health examination were enrolled. Definition and severity of erosive esophagitis were assessed using the Los Angeles classification system. Demographic data, reflux symptoms, sleep quality and duration, exercise amount, alcohol consumption, and smoking habits were recorded. Factors affecting sleep quality and sleep duration were revealed by a polytomous logistic regression analysis. Results A total of 3663 participants were recruited. Subjects with reflux symptoms, female gender, higher body mass index, and regular use of hypnotics had poorer sleep quality. Exercise was associated with better sleep quality. Either symptomatically or endoscopically, GERD did not disturb sleep duration. Among the 3158 asymptomatic patients, those with erosive esophagitis were more likely to have poor sleep quality. The risk increased with the severity of erosive changes ( p = 0.03). Conclusion The present study highlights the adverse effect of gastroesophageal reflux on sleep, even in the absence of reflux symptoms. This finding has therapeutic implications in patients with silent erosive disease, and future trials are warranted.