Sleep Disorder Associated with Gastroesophageal Reflux Disease / 대한내과학회지

ABSTRACT

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) may contribute to the development of sleep disturbance, which may, in turn, provoke or worsen GERD. We evaluated the prevalence of GERD, non-erosive reflux disease (NERD), and extra-esophageal syndrome in subjects with self-reported sleep disturbance. METHODS: Subjects presenting for a health check-up were enrolled. Valid self-administered questionnaires provided information about reflux symptoms and sleep disturbances. We defined insomnia as self-reported sleep disturbance that occurred at least twice a week. GERD was defined as at least weekly symptoms of heartburn or acid regurgitation. Factors affecting sleep disturbance were revealed by a logistic regression analysis. RESULTS: We recruited 1,701 subjects (men 57.5%; mean age 45.0 +/- 15.0 years). The prevalence of sleep disturbance was 16.3%. GERD was reported in 14.8% of the subjects with insomnia and 7.1% of controls (p < 0.001). The prevalence of NERD was 13.7% in subjects with insomnia and 6.2% in controls (p < 0.001). The prevalence of extra-esophageal symptoms was higher in the insomniacs than controls. There was a significant correlation between the number of extra-esophageal symptoms and the frequency of sleep disturbance. Multivariate analysis showed that having GERD, NERD, extra-esophageal symptoms, and high depression and anxiety scores were predictors of sleep disturbance. CONCLUSIONS: The prevalence of GERD is higher in subjects with sleep disturbance. The number of extra-esophageal symptoms was correlated with the severity of poor sleep quality, regardless of the presence of erosive change. These findings have therapeutic implications for GERD, NERD, and extra-esophageal syndrome in patients with sleep disturbance, and future trials are warranted.