Insomnia linked to increased GERD risk

Dec 9 2013

By Lucy Piper, Senior medwireNews Reporter

Insomnia is associated with an increased risk for gastroesophageal reflux disease (GERD), findings from a cross-sectional study show.

Sleep apnea syndrome, however, was not associated with GERD, despite this being the focus of most studies assessing the relationship between GERD and sleep disturbances to date.

The findings therefore highlight the need for sleep disturbances other than sleep apnea syndrome to be evaluated and correctly managed in patients with GERD, says the research team, led by In-Young Yoon (Seoul National University Bundang Hospital, Seongnam, Republic of Korea).

Among 564 Asian individuals, aged an average of 51 years, referred to a sleep clinic, 51 (9%) had GERD. These patients scored significantly higher than those without the gastric disorder on the Epworth Sleepiness Scale (average 11.28 vs 9.31), the Pittsburgh Sleep Quality Index (11.32 vs 8.31), and the Beck Depression Inventory (16.27 vs 8.35).

They also experienced more frequent spontaneous arousals during the night and consumed alcohol more often.

But there was no difference between the two groups with regard to sleep apnea-related variables or body mass index.

The researchers report in the Journal of Psychosomatic Research that the 374 patients diagnosed with insomnia had a 3.5-fold increased risk for GERD, compared with the 170 patients without insomnia, after taking into account age, gender, body mass index, frequency of alcohol consumption, and depressed mood.

The other factor significantly associated with GERD risk was depressed mood, which increased the risk 2.8-fold.

Excessive daytime sleepiness was also positively associated with GERD, but the association was no longer significant after taking into account the presence of sleep apnea.

“In managing patients with GERD, much care of psychiatric and sleep symptoms should be taken,” the authors write.

They say that the relationship between GERD and sleep disturbances is likely to be bi-directional. While acid reflux events can cause frequent night-time arousals and sleep fragmentation, sleep disturbances may alter normal esophageal clearance and in turn increase esophageal acid exposure.

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