Severity of gastroesophageal reflux disease influences daytime somnolence: A clinical study of 134 patients underwent upper panendoscopy (original) (raw)
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Gastroesophageal Reflux Disease and Sleep Quality in a Chinese Population
Journal of the Formosan Medical Association, 2009
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. [J Formos Med Assoc 2009;108(1):53-60]
Gastroesophageal Reflux Disease and Sleep
Gastroenterology Clinics of North America, 2013
Nighttime reflux during sleep plays a crucial role in several conditions associated with gastroesophageal reflux disease (GERD). Reflux patterns during arousal and sleep are different because of delayed gastric emptying, reduced esophageal peristalsis, decreases in swallowing and salivary secretion, and prolonged esophageal clearance during sleep. Clinical evidence strongly suggests that GERD is associated with sleep disturbances such as shorter sleep duration, difficulty falling asleep, arousals during sleep, poor sleep quality, and awakening early in the morning. New mechanisms on how GERD affects sleep have been recently identified by using actigraphy, and sleep deprivation was found to induce esophageal hyperalgesia to acid perfusion. Thus, the relationship between GERD and sleep disturbances is bidirectional. Among lifestyle modifications, avoidance of a late night meal plays a role in prevention of nighttime reflux. Treatment with a proton pump inhibitor (PPI) improves both nighttime symptoms and subjective sleep parameters, but its effects on objective sleep parameters remain unclear. Better control of nighttime acid secretion by administering a PPI at different times or by providing a double-dose PPI, adding H 2 receptor antagonists, or other new agents is proposed. The effects of such treatments on sleep disturbances remain to be elucidated. GERD patients with sleep disturbances report more severe symptoms and poorer quality of life as compared to those without sleep disturbances. Consequently, GERD should also be classified as GERD with sleep disturbance and GERD without sleep disturbance.
Eureka Herba Indonesia
Gastroesophageal reflux disease (GERD) is defined as a gastrointestinal motility disorder caused by the reflux of gastric contents into the esophagus or oral cavity. This results in symptoms or complications if persistent, resulting in a significant reduction in quality of life and morbidity. Several studies have reported an association between nocturnal GERD and sleep disturbances, which can significantly affect the quality of life. This study explores the relationship between sleep quality and the incidence of GERD in clinical clerkship students at the Faculty of Medicine, Universitas Prima Indonesia. This study is a cross-sectional observational study involving 144 clinical clerkship students. The GERDQ was used to diagnose GERD, and the PSQI questionnaire was used to measure sleep quality. Respondents who did not suffer from GERD with good sleep quality were 32 respondents (22.2%). Those who did not suffer from GERD with poor sleep quality were 65 respondents (74.8%), who suffer...
The effect of gastro-oesophageal reflux and omeprazole on key sleep parameters
Alimentary Pharmacology and Therapeutics, 2005
Background: The effect of gastro-oesophageal reflux on sleep and sleep quality is highly controversial. Aim: To determine the temporal relationship of abnormal objective sleep parameters to gastro-oesophageal reflux during acid suppression in patients with self diagnosed sleep disorders. Methods: Polysomnography during oesophageal pH monitoring was conducted in 16 subjects with and without gastro-oesophageal reflux as determined by a standardized questionnaire. Subjects were studied before and after omeprazole. Results: All reflux events were followed by a sleep arousal or awakening. Nocturnal acid reflux events were not predicted by the Carlsson score. Omeprazole reduced acid reflux-associated arousals from 11.6 ± 3.8 to 1.5 ± 0.8 (P < 0.01) and awakenings from 7.7 ± 1.2 to 3.7 ± 0.5 (P < 0.05). Sleep efficiency improved from 70.2% to 81.6% in a small subset of subjects with decreased sleep (P < 0.05); rapid eye movement sleep increased from 55.0 ± 4.5 to 94.5 ± 18.9 min (P < 0.05); total sleep time increased from 294.0 ± 15.9 to 345.6 ± 55.6 min (P < 0.05). Apnoea, hypopnoea and hypoxaemia were not associated with reflux. Conclusions: In subjects with gastro-oesophageal reflux, sleep arousals and awakenings are closely related to acid reflux events. Reflux-related arousals and awakenings are decreased by acid suppression. Acid suppression in selected subjects with reflux events and reduced sleep efficiency is associated with increased total sleep time, rapid eye movement sleep and sleep efficiency.
Association between Sleep Quality and Gastroesophageal Reflux in Medical Students
Middle East Journal of Digestive Diseases, 2021
BACKGROUND Due to stressful occupational conditions, irregular dietary and sleep schedules, medical students are at increased risk of developing gastrointestinal disorders, gastroesophageal reflux (GERD) in particular, as well as sleep disturbances. Therefore, for the first time, we aimed to assess the correlation between GERD and sleep disturbances among medical students. METHODS The current cross-sectional study was done on 290 medical students at different study periods in Iran during 2018-2019. Age, sex, stage of studying, residence, and body mass index were gathered. The frequency scale for the symptoms of gastroesophageal reflux (FSSG) was utilized to assess gastrointestinal symptoms among them and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Eventually, the association of sleep disturbances with demographic factors and gastrointestinal symptoms was evaluated. RESULTS Living in the dormitory (p = 0.048; OR: 1.73; 95%CI: 1.01-2.99) and being overweight (p < 0.001; OR: 3.09; 95%CI: 1.58-6.06) were independently correlated with impaired sleep quality. GERD presented either by heartburn (p < 0.001) or regurgitation (p < 0.001) was associated with a lower quality of life. CONCLUSION GERD was correlated with poor sleep quality among medical students. In addition, residence in dormitory and being overweight were correlated with poor sleep quality.
Sleep Deprivation Is Hyperalgesic in Patients With Gastroesophageal Reflux Disease
Gastroenterology, 2007
Background & Aims: Studies have demonstrated that gastroesophageal reflux disease (GERD) can cause sleep deprivation because of nighttime heartburn or short, amnestic arousals during sleep. Sleep deprivation has been associated with reports of increased GERD severity. Our aim was to determine whether sleep deprivation enhances perception of intraesophageal acid in patients with GERD vs healthy controls. Methods: Ten healthy controls and 10 patients with erosive esophagitis (grades B-D) were included in the study. All subjects were randomized to either sleep deprivation (1 night with <3 hours of sleep) or sufficient sleep (3 days with >7 hours sleep/night). Patients crossed over to the other arm after a washout period of 1 week. To ensure proper sleep time, we objectively monitored subjects with an actigraph. The morning after sufficient sleep or sleep deprivation, patients underwent stimulus response functions to esophageal acid perfusion. Results: Ten healthy controls and 10 GERD patients completed all stages of the study. GERD patients demonstrated a significant decrease in lag time to symptom report (91 ؎ 21.6 vs 282.7 ؎ 67 sec, respectively, P ؍ .02), increase in intensity rating (9.3 ؎ 1.4 vs 4.4 ؎ 0.9 cm, respectively, P ؍ .02), and increase in acid perfusion sensitivity score (48.3 ؎ 8.5 vs 22.7 ؎ 4.5 sec ؋ cm/100, respectively, P ؍ .02) after sleep deprivation as compared with nights of good sleep. Normal subjects did not demonstrate any differences in stimulus response functions to acid between sufficient sleep and sleep deprivation (578 ؎ 164 vs 493.8 ؎ 60.3 sec, 0.3 ؎ 0.2 vs 0.45 ؎ 0.2 cm, and 0.4 ؎ 0.3 vs 2.4 ؎ 1.4 sec ؋ cm/100, respectively, all P ؍ NS). Conclusions: Sleep deprivation is hyperalgesic in patients with GERD and provides a potential mechanism for increase in GERD symptom severity in sleep-deprived patients.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2007
Nighttime reflux has been shown to be associated with esophageal mucosal injury, complications, and extra-esophageal manifestations. However, few studies have assessed the impact of gastroesophageal reflux on reported quality of sleep and quality of sleep on gastroesophageal reflux. The aims of this study were (1) to determine the correlation between the severity of gastroesophageal reflux disease (GERD) symptoms and esophageal acid contact time and subjects' perceived quality of sleep; (2) to investigate the correlation between reported quality of sleep of the night prior and severity of GERD symptoms and esophageal acid contact time the following day; and (3) to define in a sleep laboratory the correlation between acid reflux events and sleep architecture. Subjects with typical GERD symptoms > or =3 times a week underwent upper endoscopy and pH monitoring. These subjects subsequently completed the GERD Symptom Assessment Score (GSAS), and the Sleep Heart Health Study Sleep ...
J Sleep Res, 2010
Repetitive airway occlusion during sleep in patients with obstructive sleep apnoea (OSA) results in the generation of negative intrathoracic pressures and ends in arousal, both of which may predispose to reflux during sleep (nocturnal reflux). We aimed to determine and compare the prevalence of nocturnal reflux symptoms and their sleepassociated risk factors in untreated OSA patients, OSA patients using continuous positive airway pressure (CPAP) therapy, and the general population. Gastrooesophageal reflux and sleep questionnaires were completed by 1116 patients with polysomnography diagnosed OSA and by 1999 participants of the 2007 Busselton population health survey. Of the OSA patients, 137 completed the reflux questionnaire before and after treatment. Risk of OSA in the general population was assessed using the Berlin score. The prevalence of frequent (>weekly) nocturnal reflux symptoms was increased (P < 0.001) in OSA patients (10.2%) versus the general population (5.5%), in individuals from the general population at high (8.7%) versus low risk (4.3%) of OSA and in patients with severe (13.9%) versus mild OSA (5.1%). Frequent nocturnal reflux symptoms were associated with high risk (general population) (OR 1.9, P < 0.01) and severity of OSA (OSA population) OR 3.0, severe versus mild OSA, P < 0.001) after correcting for age, gender and body mass index. Treatment with CPAP decreased the prevalence of reflux symptoms significantly. In conclusion, the prevalence of nocturnal reflux symptoms is increased in those with or suspected of having OSA. This association is independent of other risk factors including age, gender and body mass index, suggesting a causal relationship between OSA and nocturnal reflux. k e y w o r d s acid regurgitation, gastro-oesophageal reflux, heartburn, obstructive sleep apnoea