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Sleep Disorder Associated with Gastroesophageal Reflux Disease  

Choi, Ju-Young (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine)
Jung, Hye-Kyung (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine)
Roh, Sun-Hee (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine)
Tae, Chung-Hyun (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine)
Kim, Seong-Eun (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine)
Shim, Ki-Nam (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine)
Jung, Sung-Ae (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine)
Publication Information
The Korean Journal of Medicine / v.81, no.5, 2011 , pp. 602-610 More about this Journal
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 ${\pm}$ 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.
Keywords
Insomnia; Gastroesophageal reflux disease; Non-erosive reflux disease; Extra-esophageal syndrome;
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