Hiramoto Keiko, Fujiwara Yasuhiro, Ochi Masahiro, Okuyama Masatsugu, Tanigawa Tetsuya, Yamagami Hirokazu, Shiba Masatsugu, Watanabe Kenji, Watanabe Toshio, Tominaga Kazunari, Arakawa Tetsuo
Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Intern Med. 2015;54(6):559-65. doi: 10.2169/internalmedicine.54.3718. Epub 2015 Jan 15.
Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Although treatment with proton pump inhibitors (PPIs) helps to improve GERD symptoms and subjective sleep parameters, the effects of PPI therapy on objective sleep parameters are conflicting. The aim of this study was to examine the effects of esomeprazole treatment on GERD symptoms and sleep parameters assessed using actigraphs and questionnaires.
Thirteen patients with GERD received 20 mg of esomeprazole once daily for two weeks. The patients wore actigraphs from three days before the initiation of PPI treatment to the end of therapy. They were also asked to answer the following self-reported questionnaires: Frequency Scale for the Symptoms of GERD (FSSG), Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective sleep parameters were evaluated using actigraphy.
Treatment with esomeprazole significantly decreased the total FSSG score, including the scores for reflux and dysmotility, as well as the ESS score, although it had no effect on the PSQI score. After the second week of treatment, esomeprazole significantly decreased the wake time (from 47.5±39.6 min to 36.0±27.1 min) and sleep latency period (from 19.5±19.8 min to 9.9±10.2 min) and increased the percentage of sleep time (from 89.1±8.8% to 91.9±6.3%); however, improvements were not noted in all objective parameters.
Esomeprazole treatment significantly improves various objective sleep parameters in Japanese patients with GERD. Further placebo-controlled randomized trials are needed to obtain detailed results.
胃食管反流病(GERD)与睡眠障碍密切相关。尽管质子泵抑制剂(PPI)治疗有助于改善GERD症状和主观睡眠参数,但PPI治疗对客观睡眠参数的影响存在争议。本研究旨在探讨埃索美拉唑治疗对GERD症状以及使用活动记录仪和问卷评估的睡眠参数的影响。
13例GERD患者每天服用1次20mg埃索美拉唑,持续2周。患者在PPI治疗开始前3天至治疗结束期间佩戴活动记录仪。他们还被要求回答以下自我报告问卷:GERD症状频率量表(FSSG)、匹兹堡睡眠质量指数(PSQI)和爱泼华嗜睡量表(ESS)。使用活动记录仪评估客观睡眠参数。
埃索美拉唑治疗显著降低了FSSG总分,包括反流和动力障碍得分,以及ESS得分,尽管对PSQI得分没有影响。治疗第2周后,埃索美拉唑显著缩短了觉醒时间(从47.5±39.6分钟降至36.0±27.1分钟)和睡眠潜伏期(从19.5±19.8分钟降至9.9±10.2分钟),并增加了睡眠时间百分比(从89.1±8.8%增至91.9±6.3%);然而,并非所有客观参数都有改善。
埃索美拉唑治疗可显著改善日本GERD患者的各种客观睡眠参数。需要进一步进行安慰剂对照随机试验以获得详细结果。