Section of Gastroenterology and Hepatology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA.
Neurogastroenterol Motil. 2014 Mar;26(3):346-52. doi: 10.1111/nmo.12265. Epub 2013 Dec 9.
Gastroesophageal reflux disease (GERD) reduces sleep quality. Whether Barrett's esophagus (BE) affects sleep differently is unknown. Obstructive sleep apnea (OSA) often coexists with GERD and may disrupt sleep; whether GERD reduces sleep quality independently of OSA is unknown. Our aims were to compare the effect of GERD and BE on sleep quality, and assess the impact of OSA on this association.
Validated questionnaires for GERD symptoms, sleep quality, and OSA risk were prospectively administered to subjects undergoing upper endoscopy. GERD was defined by erosive esophagitis and/or reflux symptoms >1/week. BE was defined histologically. Controls had normal endoscopy and were asymptomatic. Poor sleep quality was defined by a Pittsburgh Sleep Quality Index score >5. Risk of OSA was defined by a positive Berlin Questionnaire. The risk poor sleep quality in GERD, BE, and controls was evaluated in multivariate models.
83 GERD, 63 BE, and 75 controls were included. OSA and poor sleep quality were significantly more frequent in GERD (65% and 60%) but not BE (52% and 46%) compared with controls (48% and 39%). Controlling for age, race, gender, smoking, body mass index, and hypertension, the risk of poor sleep quality was significantly increased in GERD compared with controls (odds ratio [OR] = 2.79, 95% confidence interval [CI]: 1.08-6.80), significance was lost after adding OSA to the model (OR = 2.27, 95% CI: 0.87-5.85).
CONCLUSIONS & INFERENCES: GERD but not BE increases the risk of poor sleep quality. This association is not independent of OSA.
胃食管反流病（GERD）会降低睡眠质量。巴雷特食管（BE）是否会对睡眠产生不同的影响尚不清楚。阻塞性睡眠呼吸暂停（OSA）常与 GERD 并存，并可能扰乱睡眠；GERD 是否会在不伴有 OSA 的情况下独立降低睡眠质量尚不清楚。我们的目的是比较 GERD 和 BE 对睡眠质量的影响，并评估 OSA 对这种关联的影响。
前瞻性地向接受上消化道内镜检查的受试者发放 GERD 症状、睡眠质量和 OSA 风险的经过验证的问卷。GERD 通过糜烂性食管炎和/或每周>1 次的反流症状来定义。BE 通过组织学来定义。对照组内镜检查正常且无症状。睡眠质量差定义为匹兹堡睡眠质量指数评分>5。OSA 风险通过柏林问卷来定义。在多变量模型中评估 GERD、BE 和对照组中睡眠质量差的风险。
共纳入 83 例 GERD、63 例 BE 和 75 例对照组。与对照组（48%和 39%）相比，GERD（65%和 60%）而非 BE（52%和 46%）中 OSA 和睡眠质量差更为常见。在控制年龄、种族、性别、吸烟、体重指数和高血压后，与对照组相比，GERD 患者睡眠质量差的风险显著增加（比值比[OR] = 2.79，95%置信区间[CI]：1.08-6.80），但在将 OSA 添加到模型后，该关联不再显著（OR = 2.27，95% CI：0.87-5.85）。
GERD 而非 BE 会增加睡眠质量差的风险。这种关联与 OSA 无关。
