Mody Reema, Bolge Susan C, Kannan Hema, Fass Ronnie
Takeda Pharmaceuticals North America, Inc, Deer Field, Illinois, USA.
Clin Gastroenterol Hepatol. 2009 Sep;7(9):953-9. doi: 10.1016/j.cgh.2009.04.005. Epub 2009 Apr 16.
BACKGROUND & AIMS: Nighttime symptoms of gastroesophageal reflux disease (GERD) are prevalent and have negative effects on sleep quality. We quantified the effects of GERD symptoms on sleep difficulties and their effects on outcomes.
Data were obtained from a patient-reported survey conducted in 2006 among the general US population. Respondents who had experienced GERD symptoms at least twice during the past month were categorized as GERD patients and were subclassified into groups on the basis of nighttime symptoms and sleep difficulties. Outcomes included health care resource use in past 6 months, work productivity and activity impairment (WPAI), and health-related quality of life (HRQOL) based on results of the Short-Form Health Survey (SF-8). Regression analysis was used to adjust for demographics and clinical characteristics.
Of 11,685 survey respondents with GERD, 88.9% experienced nighttime symptoms, 68.3% sleep difficulties, 49.1% difficulty initiating asleep (induction symptoms), and 58.3% difficulty maintaining sleep (maintenance symptoms). Respondents with nighttime GERD symptoms were more likely to experience sleep difficulties (odds ratio, 1.53) and difficulties with induction (odds ratio, 1.43) and maintenance (odds ratio, 1.56) of sleep (P < .001 for all). Sleep difficulties were associated with 0.9 additional provider visits, a 5.5% increase in overall work impairment, a 10.9% increase in activity impairment, and reductions of 3.1 and 3.6 points in SF-8 physical and mental summary scores, respectively.
Nighttime GERD symptoms are associated with interruption of sleep induction and maintenance and result in considerable economic burden and reduction in HRQOL.
胃食管反流病(GERD)的夜间症状很常见,且会对睡眠质量产生负面影响。我们对GERD症状对睡眠困难的影响及其对结局的影响进行了量化。
数据来自2006年在美国普通人群中进行的一项患者报告调查。在过去一个月中至少经历过两次GERD症状的受访者被归类为GERD患者,并根据夜间症状和睡眠困难进一步细分。结局包括过去6个月的医疗资源使用情况、工作效率和活动障碍(WPAI),以及基于简短健康调查问卷(SF-8)结果的健康相关生活质量(HRQOL)。采用回归分析对人口统计学和临床特征进行校正。
在11685名有GERD的调查受访者中,88.9%有夜间症状,68.3%有睡眠困难,49.1%入睡困难(诱导症状),58.3%维持睡眠困难(维持症状)。有夜间GERD症状的受访者更有可能出现睡眠困难(优势比,1.53)以及入睡(优势比,1.43)和维持睡眠(优势比,1.56)困难(所有P<0.001)。睡眠困难与额外0.9次就诊、总体工作障碍增加5.5%、活动障碍增加10.9%以及SF-8身体和精神总结评分分别降低3.1分和3.6分相关。
夜间GERD症状与入睡和维持睡眠的中断有关,并导致相当大的经济负担和HRQOL下降。