目的:胃食管反流病(GERD)和心理压力与睡眠障碍有关。本研究的目的是检查睡眠障碍的患病率,焦虑,和抑郁症的GERD亚型,并确定与一般人群睡眠障碍相关的因素。
方法:总共2002个日语科目,每年接受健康检查,被登记并被要求填写一份问卷,包括GERD症状的频率量表(FSSG),雅典失眠量表(AIS),罗马三号问卷,医院焦虑和抑郁量表(HADS)。GERD分为无症状糜烂性反流病(a-ERD),有症状的ERD(s-ERD),和非糜烂性反流病(NERD),根据内镜检查有无食管黏膜损伤,和FSSG分数。在AIS评分≥6的受试者中诊断出睡眠障碍。
结果:GERD受试者的睡眠障碍患病率明显高于对照组(35.9%和14.7%,分别),尤其是,NERD组(45.1%)。与其他组相比,s-ERD组的睡眠时间明显缩短。NERD和s-ERD组的受试者表现出更高的HADS评分,导致焦虑和抑郁的发生率高于对照组和a-ERD组。反流症状,焦虑,抑郁症,和共存的功能性消化不良,但不存在食管粘膜损伤,与睡眠障碍的比值比增加有关。
结论:反流症状之间存在显著正相关,心理压力,和日本成年人的睡眠障碍。需要进一步研究治疗的功效。
OBJECTIVE: Gastroesophageal reflux disease (GERD) and psychological stress are associated with sleep disturbances. The aim of the present study was to examine the prevalence of sleep disturbances, anxiety, and depression by GERD subtypes and to identify factors associated with sleep disturbances in general population.
METHODS: A total of 2002 Japanese subjects, who underwent annual health checkups, were enrolled and asked to fill out a questionnaire, including the frequency scale for the symptoms of GERD (FSSG), Athens Insomnia Scale (AIS), Rome III questionnaire, and Hospital Anxiety and Depression Scale (HADS). GERD was divided into asymptomatic erosive reflux disease (a-ERD), symptomatic ERD (s-ERD), and non-erosive reflux disease (NERD), according to the presence or absence of esophageal mucosal injury on endoscopy, and the FSSG scores. Sleep disturbances were diagnosed in subjects with AIS score ≥6.
RESULTS: Prevalence of sleep disturbances was significantly higher in GERD subjects than in controls (35.9 and 14.7%, respectively), especially, in the NERD group (45.1%). Sleep duration was significantly shorter in the s-ERD group compared with other groups. Subjects in the NERD and s-ERD groups showed higher HADS scores, resulting in higher incidences of anxiety and depression than those in the control and a-ERD groups. Reflux symptoms, anxiety, depression, and coexisting functional dyspepsia, but not the presence of esophageal mucosal injury, were associated with an increased odds ratio for sleep disturbances.
CONCLUSIONS: There were significant positive associations among reflux symptoms, psychological stress, and sleep disturbance in Japanese adults. Further studies investigating the efficacy of therapy are needed.