Nakamura Fumihiko, Kuribayashi Shiko, Tanaka Fumio, Kawami Noriyuki, Fujiwara Yasuhiro, Iwakiri Katsuhiko, Kusano Motoyasu, Uraoka Toshio
Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi City, Gunma, 371-8511, Japan.
Digestive Disease Center, Kohseichuo General Hospital, 1-11-7 Mita, Meguro-ku, Tokyo, 153-8581, Japan.
BMC Gastroenterol. 2021 Feb 18;21(1):78. doi: 10.1186/s12876-021-01659-y.
BACKGROUND/AIMS: Functional dyspepsia (FD) is often comorbid with sleep disturbance. However, it is not fully understood how sleep disturbance affects the pathophysiology of FD. We aimed to investigate the relationship between FD and sleep disturbance.
We prospectively enrolled 20 FD patients with sleep disturbance between December 2018 and July 2019. Patients took sleep aids for 4 weeks and filled out questionnaires before and after taking sleep aids. Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Athens Insomnia Scale (AIS) were used to evaluate the severity of their sleep disturbance. Modified Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (mFSSG), Gastrointestinal Symptom Rating Scale (GSRS), and the Japanese version of Patient Assessment of Constipation Quality of Life (JPAC-QOL) were used to evaluate the severity of GI symptoms. Short-Form 36-Item Health Survey (SF-36) was used to evaluate QOL. Pre- and post-sleep medication values of questionnaires were compared.
Among 20 enrolled patients, 16 completed the study protocol. Zolpidem, eszopiclone, and suvorexant were administered to six, nine, and one patient, respectively. Each median total score of questionnaires (pre-/post-sleep medication, respectively) was as follows: PSQI, 10.0/8.5; ESS, 12.5/5.0; AIS, 10.0/4.0; mFSSG, 21.0/16.0; GSRS, 44.0/31.0 (Pain in GSRS, 11.0/5.0); JPAC-QOL, 26.0/15.5; SF-36, 63.9/71.9. All of these results showed statistically significant differences between pre- and post-sleep medication (p < 0.05).
Improvement of sleep disturbance by administration of sleep aids resulted in improvement of GI symptoms and QOL in patients with FD. This effect may be related to pain modification.
背景/目的:功能性消化不良(FD)常与睡眠障碍合并存在。然而,睡眠障碍如何影响FD的病理生理学尚未完全明确。我们旨在研究FD与睡眠障碍之间的关系。
2018年12月至2019年7月,我们前瞻性纳入了20例伴有睡眠障碍的FD患者。患者服用助眠药物4周,并在服药前后填写问卷。采用匹兹堡睡眠质量指数(PSQI)、爱泼华嗜睡量表(ESS)和雅典失眠量表(AIS)评估其睡眠障碍的严重程度。采用改良的胃食管反流病症状频率量表(mFSSG)、胃肠道症状评定量表(GSRS)以及日本版便秘患者生活质量评估量表(JPAC-QOL)评估胃肠道症状的严重程度。采用简明健康调查36项量表(SF-36)评估生活质量。比较睡眠药物治疗前后问卷的值。
20例纳入患者中,16例完成了研究方案。分别有6例、9例和1例患者服用了唑吡坦、右佐匹克隆和苏沃雷生。各问卷的中位数总分(睡眠药物治疗前/后,分别)如下:PSQI,10.0/8.5;ESS,12.5/5.0;AIS,10.0/4.0;mFSSG,21.0/16.0;GSRS,44.0/31.0(GSRS中的疼痛,11.0/5.0);JPAC-QOL,26.0/15.5;SF-36,63.9/71.9。所有这些结果在睡眠药物治疗前后均显示出统计学显著差异(p<0.05)。
服用助眠药物改善睡眠障碍可使FD患者的胃肠道症状和生活质量得到改善。这种作用可能与疼痛改善有关。