1
|
Huang Y, Liu J, Xu L, Qi W, Dai J, Wang B, Tian J, Fu X, Yu Y. Exacerbation of symptoms, nocturnal acid reflux, and impaired autonomic function are associated with sleep disturbance in gastroesophageal reflux disease patients. Front Med (Lausanne) 2024; 11:1438698. [PMID: 39234038 PMCID: PMC11371777 DOI: 10.3389/fmed.2024.1438698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 08/07/2024] [Indexed: 09/06/2024] Open
Abstract
Background and aim Gastroesophageal reflux disease (GERD) patients often report sleep disturbance (SD); however, the relationship between GERD and SD is unknown. This study investigated whether SD affects symptoms, acid reflux, and autonomic function in GERD patients. Methods A total of 257 subjects (126 patients with SD and 99 patients without SD) participated in this survey from January 2020 to August 2022. Participants were required to complete questionnaires including the GERD impact scale (GIS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD). Esophageal mucosal injury, acid exposure, peristaltic function, and autonomic function were assessed by upper endoscopy, high-resolution esophageal manometry (HRAM), 24-h multichannel intraluminal impedance with pH (24 h-MII-pH), and electrocardiography (ECG). Results Gastroesophageal reflux disease patients with SD experienced a higher frequency of prolonged reflux (p < 0.001), longest reflux event (p < 0.001), acid exposure time (p < 0.001) during the recumbent period, and a higher incidence of erosive esophagitis (EE) (59.5 vs. 45.5%, p = 0.036) than those without SD. Pearson's correlation analysis showed that SD was positively correlated with GIS (r = 0.725, p < 0.001), HAMA (r = 0.680, p < 0.001), and HAMD (r = 0.323, p < 0.001) scores, and negatively correlated with parasympathetic or vagal nerve activity (r = -0.770, p < 0.001). Conclusion Gastroesophageal reflux disease patients with SD experience more severe reflux symptoms and nocturnal acid reflux, which may be related to autonomic dysfunction.
Collapse
Affiliation(s)
- Yizhou Huang
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Jie Liu
- Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Linsheng Xu
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Wu Qi
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Jie Dai
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Bo Wang
- Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jiashuang Tian
- Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xin Fu
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Yue Yu
- Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| |
Collapse
|
2
|
Erfanian R, Pouremamali R, Zamani R, Moazeni SA, Borghei P. Globus sensation in obstructive sleep apnea patients; A cross-sectional study of 120 patients. Sleep Breath 2024:10.1007/s11325-024-03087-0. [PMID: 38884696 DOI: 10.1007/s11325-024-03087-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Globus pharyngeus (GP) is a common complaint in many disciplines, especially otolaryngology. Pharyngeal symptoms and abnormalities, including GP, are frequent in obstructive sleep apnea (OSA) patients. This study aims to investigate globus sensation in non-operated OSA patients. METHODS After translation and validation, the Laryngopharyngeal Measure of Perceived Sensation (LUMP) was administered to 120 untreated OSA patients. All patients underwent polysomnography and thorough physical examination. The association between LUMP scores and OSA measures was evaluated. RESULTS LUMP score had a significant correlation with the Epworth Sleepiness Scale (ESS) (Spearman's ρ = 0.269, p = 0.004), and BMI (Spearman's ρ = 0.249, p = 0.007), the anatomical position of the tongue (ρ = -0.191, p = 0.04) and the Friedman grade of tonsils (ρ = 0.241, p = 0.01). It correlated with SpO2 nadir, though it did not reach statistical significance. CONCLUSION The results of our study depict a relationship between a self-report measure of globus sensation and daytime sleepiness, BMI and tonsil size. In the absence of a direct relationship between OSA severity parameters and GP, we hypothesize a role for shared comorbidities and anatomical phenotypes. The increased frequency of GP in OSA patients should be considered when evaluating the complications of surgical interventions in these patients.
Collapse
Affiliation(s)
- Reza Erfanian
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rozhina Pouremamali
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Raha Zamani
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Atiyeh Moazeni
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Borghei
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Tan X, Wang S, Wu F, Zhu J. Bidirectional correlation between gastroesophageal reflux disease and sleep problems: a systematic review and meta-analysis. PeerJ 2024; 12:e17202. [PMID: 38646475 PMCID: PMC11027907 DOI: 10.7717/peerj.17202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/15/2024] [Indexed: 04/23/2024] Open
Abstract
Objectives Gastroesophageal reflux disease (GERD) and sleep problems are highly prevalent among the general population. Both them are associated with a variety of psychiatric disorders such as depression and anxiety, which is highlighting an underexplored connection between them. This meta-analysis aims to explore the association between sleep problems and GERD. Methods We conducted a comprehensive search on PubMed, Cochrane Library, Embase, and Web of Science, using Medical Subject Headings (MeSH) and keywords, covering articles from the inception of the databases until August 2023. Stata statistical software, version 14.0, was utilized for all statistical analyses. A fixed-effects model was applied when p > 0.1 and I2 ≤ 50%, while a random-effects model was employed for high heterogeneity (p < 0.1 and I2 > 50%). Funnel plots and Egger's test were used to assess publication bias. Results Involving 22 studies, our meta-analysis revealed that insomnia, sleep disturbance, or short sleep duration significantly increased the risk of GERD (OR = 2.02, 95% CI [1.64-2.49], p < 0.001; I2 = 66.4%; OR = 1.98, 95% CI [1.58-2.50], p < 0.001, I2 = 50.1%; OR = 2.66, 95% CI [2.02-3.15], p < 0.001; I2 = 62.5%, respectively). GERD was associated with an elevated risk of poor sleep quality (OR = 1.47, 95% CI [1.47-1.79], p < 0.001, I2 = 72.4%), sleep disturbance (OR = 1.47, 95% CI [1.24-1.74], p < 0.001, I2 = 71.6%), or short sleep duration (OR = 1.17, 95% CI [1.12-1.21], p < 0.001, I2 = 0). Conclusion This meta-analysis establishes a bidirectional relationship between four distinct types of sleep problems and GERD. The findings offer insights for the development of innovative approaches in the treatment of both GERD and sleep problems.
Collapse
Affiliation(s)
- Xiaolong Tan
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, Shandong Province, China
| | - Shasha Wang
- Department of Oncology, The People’s Hospital of Binzhou City, Binzhou, Shandong Province, China
| | - Fengjie Wu
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, Shandong Province, China
| | - Jun Zhu
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, Shandong Province, China
| |
Collapse
|
4
|
Elkalawy H, Abosena W, Elnagger M, Allison H. Wake up to gastro-oesophageal reflux disease: The interplay between arousal and night-time reflux. J Sleep Res 2024:e14158. [PMID: 38356205 DOI: 10.1111/jsr.14158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/16/2024]
Abstract
This review examines the temporal association between nocturnal gastro-oesophageal reflux and sleep-arousal cycles. Most nocturnal gastro-oesophageal reflux events occur during the awake cycle, and arousals precede most nocturnal gastro-oesophageal reflux events, indicating that arousal from sleep predisposes to nocturnal gastro-oesophageal reflux. This sheds light on the complex relationship between nocturnal gastro-oesophageal reflux and sleep, and has implications for managing nocturnal gastro-oesophageal reflux symptoms. The appearance of symptoms and the pathophysiology of nocturnal gastro-oesophageal reflux are influenced by sleep hygiene, sleep disturbances and the misalignment of circadian rhythms. Nocturnal gastro-oesophageal reflux and its related sleep disorders are prevalent and negatively impact the quality of life. There is conflicting evidence on whether nocturnal gastro-oesophageal reflux and sleep disturbances are causally linked, and whether sleep disturbances drive nocturnal gastro-oesophageal reflux. Poor sleep quality increases oesophageal hypersensitivity and overall acid exposure. The nocturnal gastro-oesophageal reflux is linked to the more severe forms of gastro-oesophageal reflux disease, especially with atypical/extra-oesophageal manifestations and complications of mucosal damage such as oesophagitis and stricture, Barret's oesophagus, and oesophageal adenocarcinoma. This review highlights the role of sleep problems in presenting nocturnal gastro-oesophageal reflux, and the potential benefits of treating sleep disturbances in enhancing patient care and quality of life.
Collapse
Affiliation(s)
- Hanan Elkalawy
- Department of Anesthesiology and Perioperative Care, Tufts Medical Center, Boston, Massachusetts, USA
| | - Wael Abosena
- Department of Surgery, Faculty of Medicine, Tanta University, Gharbeya, Egypt
| | - Mohamed Elnagger
- Department of Internal Medicine, Hartford Health Care, Hartford, Connecticut, USA
| | - Harmony Allison
- Department of Internal Medicine, Tufts Medical Center, Boston, Massachusetts, USA
| |
Collapse
|
5
|
Hungin AP, Yadlapati R, Anastasiou F, Bredenoord AJ, El Serag H, Fracasso P, Mendive JM, Savarino EV, Sifrim D, Udrescu M, Kahrilas PJ. Management advice for patients with reflux-like symptoms: an evidence-based consensus. Eur J Gastroenterol Hepatol 2024; 36:13-25. [PMID: 38006602 PMCID: PMC10695341 DOI: 10.1097/meg.0000000000002682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/11/2023] [Indexed: 11/27/2023]
Abstract
Patients with reflux-like symptoms (heartburn and regurgitation) are often not well advised on implementing individualised strategies to help control their symptoms using dietary changes, lifestyle modifications, behavioural changes or fast-acting rescue therapies. One reason for this may be the lack of emphasis in management guidelines owing to 'low-quality' evidence and a paucity of interventional studies. Thus, a panel of 11 gastroenterologists and primary care doctors used the Delphi method to develop consolidated advice for patients based on expert consensus. A steering committee selected topics for literature searches using the PubMed database, and a modified Delphi process including two online meetings and two rounds of voting was conducted to generate consensus statements based on prespecified criteria (67% voting 'strongly agree' or 'agree with minor reservation'). After expert discussion and two rounds of voting, 21 consensus statements were generated, and assigned strength of evidence and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) rating. Eleven statements achieved the strongest (100%) agreement: five are related to diet and include identification and avoidance of dietary triggers, limiting alcohol, coffee and carbonated beverages, and advising patients troubled by postprandial symptoms not to overeat; the remaining six statements concern advice around smoking cessation, weight loss, raising the head-of-the-bed, avoiding recumbency after meals, stress reduction and alginate use. The aim of developing the consensus statements is that they may serve as a foundation for tools and advice that can routinely help patients with reflux-like symptoms better understand the causes of their symptoms and manage their individual risk factors and triggers.
Collapse
Affiliation(s)
- A. Pali Hungin
- Professor Emeritus, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Rena Yadlapati
- Division of Gastroenterology, University of California San Diego, La Jolla, California, USA
| | - Foteini Anastasiou
- 4th Local Primary Care Team, Municipality Practice and Academic Practice of Heraklion; University of Crete, Crete, Greece
| | - Albert J. Bredenoord
- Department of Gastroenterology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Hashem El Serag
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Pierluigi Fracasso
- Department of Gastroenterology and Digestive Endoscopy, Ospedale Sandro Pertini, Local Health Agency Roma 2, Rome, Italy
| | - Juan M Mendive
- La Mina Primary Care Academic Centre, Catalan Health Institute, University of Barcelona, Spain
| | - Edoardo V. Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Daniel Sifrim
- Wingate Institute of Neurogastroenterology, Queen Mary University of London, London, UK
| | | | - Peter J Kahrilas
- Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
6
|
Liu D, Xu L, Chen L, Hu J, Wu D, Wang G, Shen H, Zhang X, Ji Y, Ruan L, Lou Z. TRPV1 is a risk factor for sleep disturbance in patients with gastro-oesophageal reflux disease: a case control study. Scand J Gastroenterol 2023; 58:844-855. [PMID: 36924259 DOI: 10.1080/00365521.2023.2190438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/10/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND/AIMS Gastro-oesophageal reflux disease (GORD) is a chronic high-morbidity disease with a bidirectional relationship with sleep disturbance (SD) that may occur via the transient receptor potential vanilloid type 1 receptor (TRPV1) in the oesophageal mucosa. Yet the related mechanism was still unclear, the aim of this study is to investigate whether TRPV1 is associated with the presence of SD in GORD patients. METHODS A case-control study was performed. After the screening, A total of 88 subjects were assigned to GORD without sleep disturbance (GORD + NOSD, n = 28), GORD comorbid sleep disturbance (GORD + SD, n = 30) and matched healthy controls (n = 30). Mucosal tissue was obtained from the participants by digestive endoscopy, the levels of TRPV1 expressed in the oesophageal mucosa were detected via RT-qPCR and western blot in different groups, and the correlation between GORD and SD were also analysed. RESULTS In this study, we found that the Gastroesophageal Reflux Disease Diagnostic Questionnaire (GerdQ) scores was positively correlated with Pittsburgh Sleep Quality Index (PSQI) scores but negatively correlated with total sleep time (TST). We also found that the level of TRPV1 expressed in the oesophageal mucosa of GORD + SD was significantly higher than GORD + NOSD patients, and they were all higher than healthy controls. CONCLUSION The current study suggested a closer link exists between GORD and sleep disturbance, and TRPV1 in oesophageal mucosa may be a crucial factor affecting sleep in GORD patients.
Collapse
Affiliation(s)
- Denong Liu
- Department of Pharmacology, School of Medicine, Zhejiang Key Laboratory of Pathophysiology, Ningbo University, Ningbo, Zhejiang, China
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Lei Xu
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Lei Chen
- Department of Pharmacology, School of Medicine, Zhejiang Key Laboratory of Pathophysiology, Ningbo University, Ningbo, Zhejiang, China
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Jieqiong Hu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Danjuan Wu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Guanjun Wang
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Haowei Shen
- Department of Pharmacology, School of Medicine, Zhejiang Key Laboratory of Pathophysiology, Ningbo University, Ningbo, Zhejiang, China
| | - Xiaoqin Zhang
- Department of Pharmacology, School of Medicine, Zhejiang Key Laboratory of Pathophysiology, Ningbo University, Ningbo, Zhejiang, China
| | - Yunxin Ji
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Liemin Ruan
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Zhongze Lou
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
- Zhejiang Key Laboratory of Precision Medicine for Atherosclerotic Diseases, Central Laboratory of the Medical Research Center, The First Affiliated Hospital of Ningbo Universit, Ningbo First Hospital, Ningbo, Zhejiang, China
| |
Collapse
|
7
|
Zhao X, Ding R, Su C, Yue R. Sleep traits, fat accumulation, and glycemic traits in relation to gastroesophageal reflux disease: A Mendelian randomization study. Front Nutr 2023; 10:1106769. [PMID: 36895273 PMCID: PMC9988956 DOI: 10.3389/fnut.2023.1106769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023] Open
Abstract
Background Sleep traits, fat accumulation, and glycemic traits are associated with gastroesophageal reflux disease (GERD) in observational studies. However, whether their associations are causal remains unknown. We performed a Mendelian randomization (MR) study to determine these causal relationships. Methods Independent genetic variants associated with insomnia, sleep duration, short sleep duration, body fat percentage, visceral adipose tissue (VAT) mass, type 2 diabetes, fasting glucose, and fasting insulin at the genome-wide significance level were selected as instrumental variables. Summary-level data for GERD were derived from a genome-wide association meta-analysis including 78,707 cases and 288,734 controls of European descent. Inverse variance weighted (IVW) was used for the main analysis, with weighted median and MR-Egger as complements to IVW. Sensitivity analyses were performed using Cochran's Q test, MR-Egger intercept test, and leave-one-out analysis to estimate the stability of the results. Results The MR study showed the causal relationships of genetically predicted insomnia (odds ratio [OR] = 1.306, 95% confidence interval [CI] 1.261 to 1.352; p = 2.24 × 10-51), short sleep duration (OR = 1.304, 95% CI: 1.147 to 1.483, p = 4.83 × 10-5), body fat percentage (OR = 1.793, 95% CI 1.496 to 2.149; p = 2.68 × 10-10), and visceral adipose tissue (OR = 2.090, 95% CI 1.963 to 2.225; p = 4.42 × 10-117) with the risk of GERD. There was little evidence for causal associations between genetically predicted glycemic traits and GERD. In multivariable analyses, genetically predicted VAT accumulation, insomnia, and decreased sleep duration were associated with an increased risk of GERD. Conclusion This study suggests the possible roles of insomnia, short sleep, body fat percentage, and visceral adiposity in the development of GERD.
Collapse
Affiliation(s)
- Xiaoyan Zhao
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rui Ding
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chengguo Su
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rensong Yue
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
8
|
Sun X, Chen L, Zheng L. A Mendelian randomization study to assess the genetic liability of gastroesophageal reflux disease for cardiovascular diseases and risk factors. Hum Mol Genet 2022; 31:4275-4285. [PMID: 35861629 DOI: 10.1093/hmg/ddac162] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/25/2022] [Accepted: 07/11/2022] [Indexed: 01/21/2023] Open
Abstract
Observational studies have reported that gastroesophageal reflux disease (GERD) is a risk factor for cardiovascular diseases (CVD); however, the causal inferences between them remain unknown. We conducted a Mendelian randomization (MR) study to estimate the causal associations between GERD and 10 CVD outcomes, as well as 14 cardiovascular risk factors. We used summary statistics from genome-wide association studies for GERD and the FinnGen consortium for CVD. We further investigated whether GERD correlated with cardiovascular risk factors and performed multivariable MR and mediation analyses to estimate the mediating effects of these risk factors on GERD-CVD progression. Sensitivity analyses and replication analyses were also performed. Our results indicated that GERD was positively associated with seven CVD outcomes with odds ratios of 1.26 [95% confidence interval (CI), 1.15, 1.37] for coronary artery disease, 1.41 (95% CI, 1.28, 1.57) for myocardial infarction, 1.34 (95% CI, 1.19, 1.51) for atrial fibrillation, 1.34 (95% CI, 1.21, 1.50) for heart failure, 1.30 (95% CI, 1.18, 1.43) for any stroke, 1.19 (95% CI, 1.06, 1.34) for ischemic stroke and 1.29 (95% CI, 1.16, 1.44) for venous thromboembolism. Furthermore, GERD was associated with nine cardiovascular risk factors and major depressive disorder demonstrated significant mediation effects on the causal pathway linking GERD and any stroke. This study demonstrates that GERD is associated with seven CVD outcomes and nine cardiovascular risk factors. Importantly, GERD treatment may help prevent common CVD events.
Collapse
Affiliation(s)
- Xingang Sun
- Department of Cardiology and Atrial fibrillation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Lu Chen
- Department of Cardiology and Atrial fibrillation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Liangrong Zheng
- Department of Cardiology and Atrial fibrillation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| |
Collapse
|
9
|
Palomäki M, Saaresranta T, Anttalainen U, Partinen M, Keto J, Linna M. Multimorbidity and overall comorbidity of sleep apnoea: a Finnish nationwide study. ERJ Open Res 2022; 8:00646-2021. [PMID: 35677395 PMCID: PMC9168083 DOI: 10.1183/23120541.00646-2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/25/2022] [Indexed: 11/23/2022] Open
Abstract
The prevalence of sleep apnoea is increasing globally; however, population-based studies have reported a wide variation of prevalence estimates, and data on incidence of clinically diagnosed sleep apnoea are scant. Data on the overall burden of comorbidities or multimorbidity in individuals with incident sleep apnoea are scarce, and the pathways to multimorbidity have only marginally been studied. To study the current epidemiology of sleep apnoea in Finland, overall burden of comorbidities, and multimorbidity profiles in individuals with incident sleep apnoea, we conducted a register-based, nationwide, retrospective study of data from January 2016 to December 2019. The prevalence of clinically diagnosed sleep apnoea was 3.7% in the Finnish adult population; 1-year incidence was 0.6%. Multimorbidity was present in 63% of individuals at the time of sleep apnoea diagnosis. Of those with incident sleep apnoea, 34% were heavily multimorbid (presenting with four or more comorbidities). The three most common chronic morbidities before sleep apnoea diagnosis were musculoskeletal disease, hypertension and cardiovascular disease. In multimorbid sleep apnoea patients, hypertension and metabolic diseases including obesity and diabetes, cardiovascular diseases, musculoskeletal diseases and dorsopathies, in different combinations, encompassed the most frequent disease pairs preceding a sleep apnoea diagnosis. Our study adds to the few population-based studies by introducing overall and detailed figures on the burden of comorbidities in sleep apnoea in a nationwide sample and provides up-to-date information on the occurrence of sleep apnoea as well as novel insights into multimorbidity in individuals with incident sleep apnoea. Two-thirds of individuals with sleep apnoea are multimorbid at diagnosis and one-third are heavily multimorbid. Dorsopathies, musculoskeletal diseases, hypertension and metabolic diseases are the most common comorbidities preceding sleep apnoea diagnosis.https://bit.ly/36WMlX1
Collapse
|
10
|
Su J, Fang Y, Meng Y, Zhao C, Liu Y, Sun L, Wang M, Dai L, Ouyang S. Effect of Continuous Positive Airway Pressure on Chronic Cough in Patients with Obstructive Sleep Apnea and Concomitant Gastroesophageal Reflux. Nat Sci Sleep 2022; 14:13-23. [PMID: 35023978 PMCID: PMC8747786 DOI: 10.2147/nss.s341400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/23/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) and/or gastroesophageal reflux (GER) may be the contributors to chronic cough in patients with OSA and concomitant GER. This study aimed to explore whether continuous positive airway pressure (CPAP), antireflux treatment and lifestyle modifications improve chronic cough in patients with OSA and concomitant GER. METHODS Patients with OSA and concomitant GER who also experienced chronic cough were enrolled, and were divided into two groups. Patients who were treated with general treatment (antireflux treatment and lifestyle modifications) as the control group, and patients who were treated with CPAP and general treatment as the treatment group. Effects of different treatments on chronic cough were assessed, and the association among chronic cough, GER and OSA was evaluated by Pearson's correlation analysis. RESULTS The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were better in the treatment group after 1 week of treatment; further, the improvement became stronger with the duration of therapy. The gastroesophageal reflux disease questionnaire, visual analog scale (VAS) for cough, and daytime and nighttime cough symptom scores significantly improved in both groups after treatment, whereas this improvement was more significant in the treatment group. Significant associations between the apnea-hypopnea index (AHI) and VAS, weak acid reflux and VAS, and weak acid reflux and AHI were observed. CONCLUSION CPAP improved the symptoms of chronic cough and GER in patients with OSA and concomitant GER. AHI and weak acid reflux may be important factors affecting the therapeutic effect of chronic cough in patients with OSA and concomitant GER.
Collapse
Affiliation(s)
- Jiao Su
- Department of Respiratory and Sleep Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Yifei Fang
- Department of Respiratory and Sleep Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Yang Meng
- Department of Respiratory and Sleep Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Chunling Zhao
- Department of Respiratory and Sleep Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Yanjun Liu
- Department of Respiratory and Sleep Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Linge Sun
- Department of Respiratory and Sleep Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Mengge Wang
- Department of Respiratory and Sleep Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Liping Dai
- Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Songyun Ouyang
- Department of Respiratory and Sleep Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| |
Collapse
|
11
|
Associations between sleep bruxism and other sleep-related disorders in adults: a systematic review. Sleep Med 2021; 89:31-47. [PMID: 34879286 DOI: 10.1016/j.sleep.2021.11.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Systematic reviews on sleep bruxism (SB) as a comorbid condition of other sleep-related disorders are lacking. Such reviews would contribute to the insight of sleep clinicians into the occurrence of SB in patients with other sleep-related disorders, and into the underlying mechanisms of such comorbid associations. This systematic review aimed: 1. to determine the prevalence of SB in adults with other sleep-related disorders; and 2. to determine the associations between SB and other sleep-related disorders, and to explain the underlying mechanisms of these associations. METHODS A systematic search on SB and sleep-related disorders was performed in PubMed, Embase, Cochrane Library, and Web of Science to identify eligible studies published until May 15, 2020. Quality assessment was performed using the Risk of Bias Assessment tool for Non-randomized Studies. RESULTS Of the 1539 unique retrieved studies, 37 articles were included in this systematic review. The prevalence of SB in adult patients with obstructive sleep apnea, restless leg syndrome, periodic limb movement during sleep, sleep-related gastroesophageal reflux disease, REM behavior disorder (RBD), and sleep-related epilepsy was higher than that in the general population. The specific mechanisms behind these positive associations could not be identified. CONCLUSIONS SB is more prevalent in patients with the previously mentioned disorders than in the general population. Sleep arousal may be a common factor with which all the identified disorders are associated, except RBD and Parkinson's disease. The associations between SB and these identified sleep-related disorders call for more SB screening in patients with the abovementioned sleep-related disorders.
Collapse
|
12
|
Kang HH, Lim CH, Oh JH, Cho MJ, Lee SH. The Influence of Gastroesophageal Reflux Disease on Daytime Sleepiness and Depressive Symptom in Patients With Obstructive Sleep Apnea. J Neurogastroenterol Motil 2021; 27:215-222. [PMID: 32759463 PMCID: PMC8026368 DOI: 10.5056/jnm20071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/01/2020] [Accepted: 06/15/2020] [Indexed: 12/13/2022] Open
Abstract
Background/Aims As there is insufficient evidence for a relationship between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA), we investigated whether OSA diagnosed by polysomnography (PSG) is related to GERD. Methods A total of 402 subjects was evaluated. Overnight PSG was performed and a few questionnaires on GERD, anxiety, depression, and daytime sleepiness were administered. An apnea-hypopnea index < 5 was the classification criterion for subjects without OSA. Subjects with heartburn or acid regurgitation at least once a week were classified as having GERD. Results Among the 402 subjects, 318 had OSA and 84 did not. The prevalence of GERD was 12.9% among patients with OSA and 10.7% among those without (P = 0.590). The prevalence of GERD did not correlate with OSA severity (P = 0.474). Patients with OSA with GERD had higher Stanford Sleepiness Scale (P = 0.004), Epworth Sleepiness Scale (P = 0.001), and depression (P < 0.001) scores than patients with OSA without GERD. Subjects with nocturnal gastroesophageal reflux symptoms had a higher body mass index, waist-to-height ratio, and waist circumference-to-height index than those without symptoms. Multiple logistic regression showed that higher Epworth Sleepiness Scale and depression scores were independent factors associated with GERD in patients with OSA. Conclusions The prevalence of GERD in patients with OSA was 12.9%. The prevalence of GERD did not correlate with OSA severity. Daytime sleepiness and depression seem to be associated with GERD in patients with OSA, while nocturnal reflux symptoms seem to be related to obesity in OSA.
Collapse
Affiliation(s)
- Hyeon Hui Kang
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Chul-Hyun Lim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Hwan Oh
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min-Jae Cho
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Haak Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
13
|
Zhang M, Hou ZK, Huang ZB, Chen XL, Liu FB. Dietary and Lifestyle Factors Related to Gastroesophageal Reflux Disease: A Systematic Review. Ther Clin Risk Manag 2021; 17:305-323. [PMID: 33883899 PMCID: PMC8055252 DOI: 10.2147/tcrm.s296680] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/17/2021] [Indexed: 01/30/2023] Open
Abstract
We performed this review to clarify which dietary and lifestyle factors are related to gastroesophageal reflux disease. Through a systematic search of the PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and Chinese BioMedical Literature (CBM) databases, we identified articles with clear definitions of GERD, including nonerosive gastroesophageal reflux disease (NERD), reflux esophagitis (RE) and Barrett’s esophagus (BE), that included dietary and lifestyle factors as independent factors affecting the onset of GERD (expressed as odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs)). Due to heterogeneity among the studies, we used descriptive statistical analyses to analyze and synthesize each outcome based on the disease type. In total, 72 articles were included, conducted in ten Western countries (26 articles in total) and nine Eastern countries (46 articles in total). We categorized dietary factors into 20 items and lifestyle factors into 11 items. GERD is related to many irregular dietary and lifestyle habits (such as a habit of midnight snacking: OR=5.08, 95% CI 4.03–6.4; skipping breakfast: OR=2.7, 95% CI 2.17–3.35; eating quickly: OR=4.06, 95% CI 3.11–5.29; eating very hot foods: OR=1.81, 95% CI 1.37–2.4; and eating beyond fullness: OR=2.85, 95% CI 2.18–3.73). Vegetarian diets (consumption of nonvegetarian food (no/yes); OR=0.34, 95% CI 0.211–0.545) and no intake of meat (OR=0.841, 95% CI 0.715–0.990) were negatively related to GERD, while meat (daily meat, fish, and egg intake: OR=1.088, 95% CI 1.042-1.135) and fat (high–fat diet: OR=7.568, 95% CI 4.557–8.908) consumption were positively related to GERD. An interval of less than three hours between dinner and bedtime (OR=7.45, 95% CI 3.38–16.4) was positively related to GERD, and proper physical exercise (physical exercise >30 minutes (>3 times/week): OR=0.7, 95% CI 0.6–0.9) was negatively correlated with GERD. Smoking (OR=1.19, 95% CI 1.12–1.264), alcohol consumption (OR=1.278, 95% CI 1.207–1.353) and mental state (poor mental state: OR=1.278, 95% CI 1.207–1.353) were positively correlated with GERD. RE (vitamin C: OR=0.46, 95% CI=0.24–0.90) and BE (vitamin C: OR=0.44,95% CI 0.2-0.98; vitamin E: OR=0.46, 95% CI 0.26–0.83) were generally negatively correlated with antioxidant intake. In conclusion, many dietary and lifestyle factors affect the onset of GERD, and these factors differ among regions and disease types. These findings need to be further confirmed in subsequent studies.
Collapse
Affiliation(s)
- Mei Zhang
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zheng-Kun Hou
- Gastroenterology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhi-Bang Huang
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xin-Lin Chen
- Department of Preventive Medicine and Health Statistics, College of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Feng-Bin Liu
- Gastroenterology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Baiyun Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| |
Collapse
|
14
|
Poor Sleep Hygiene is Associated with Decreased Discrimination and Inattention on Continuous Performance Task in Doctor of Physical Therapy Students: A Cross-sectional Study. ACTA ACUST UNITED AC 2020; 34:160-165. [PMID: 34211256 DOI: 10.1097/jte.0000000000000135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction Reduced sleep quality impairs learning, memory formation, attention, and executive function ability. Poor sleep quality or sleep hygiene has been shown to impair academic performance of undergraduate and medical students. The purpose of this study was to examine the association between sleep quality, sleep hygiene, and cognitive performance in Doctor of Physical Therapy (DPT) students. Methods Fifty DPT students at the University of Kansas Medical Center completed the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Hygiene Index (SHI). Cognitive performance was assessed using the Continuous Performance Test (CPT) which is a test of sustained attention and the Trail-Making Task (TMT) to assess executive functioning. An actigraph was worn for one week to objectively characterize sleep outcomes. Spearman's correlations were performed to assess the association between self-report sleep quality, sleep hygiene, and outcomes on the cognitive tasks. Post-hoc Mann-Whitney and Kruskal-Wallis tests were conducted to examine group differences between sleep outcomes and cognitive performance for demographic variable categories. Results Twenty-three students (46%) reported poor sleep quality, and 27 participants (54%) had objectively-reported poor sleep quality. There was a significant positive correlation between SHI and Detectability (rs= 0.297, p= 0.036) and Omissions (rs=.343, p=0.015). There were group differences between sex and number of pets on the CPT outcomes, and there was a significant group difference between the number of drinks/week categories on the SHI. Discussion and Conclusions About half of the participants were identified as having poor sleep quality. Poorer sleep hygiene was associated with poorer discrimination and inattention, which could potentially impact the students' academic and clinical performance as well as their health and wellbeing. Also, certain demographic variables may modulate the results.
Collapse
|
15
|
Wu ZH, Yang XP, Niu X, Xiao XY, Chen X. The relationship between obstructive sleep apnea hypopnea syndrome and gastroesophageal reflux disease: a meta-analysis. Sleep Breath 2018; 23:389-397. [PMID: 29987514 PMCID: PMC6529388 DOI: 10.1007/s11325-018-1691-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/15/2018] [Accepted: 06/19/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Obstructive sleep apnea hypopnea syndrome (OSAHS) means apnea and hypopnea caused by partial or complete obstruction of upper airway collapse during sleep. Gastroesophageal reflux disease (GERD) is believed to be associated with various manifestations in the otorhinolaryngology and has been found to be an additional risk factor for OSAHS. AIM A meta-analysis was performed to identify the association between obstructive sleep apnea hypopnea syndrome and gastroesophageal reflux disease. METHODS To identify eligible original articles, we searched a series of computerized databases, including Medline via PubMed, EMBASE, Web of Science, and CNKI with a systematic searching strategy. The characteristics of each article and pooled odds ratios (ORs) with corresponding confidence intervals (CIs) were calculated and subgroup analysis was performed to analyze the source of heterogeneity. RESULTS A total of 2699 patients from seven articles were included in the meta-analysis. We identified a significant relationship between obstructive sleep apnea syndrome and gastroesophageal reflux disease, with a pooled OR of 1.75 (95% CI 1.18-2.59, P < 0.05). The pooled data was calculated under the random-effects model as a significant moderate heterogeneity was found among the meta-analysis. CONCLUSIONS The meta-analysis showed that there was a significant correlation between obstructive sleep apnea hypopnea syndrome and gastroesophageal reflux disease.
Collapse
Affiliation(s)
- Zeng-Hong Wu
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiu-Ping Yang
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xun Niu
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xi-Yue Xiao
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Xiong Chen
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| |
Collapse
|
16
|
Lee YS, Jang BH, Ko SG, Chae Y. Comorbid risks of psychological disorders and gastroesophageal reflux disorder using the national health insurance service-National Sample Cohort: A STROBE-compliant article. Medicine (Baltimore) 2018; 97:e0153. [PMID: 29718833 PMCID: PMC6393012 DOI: 10.1097/md.0000000000010153] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
This study was performed to examine the comorbidity risks between psychological disorders, such as depression, and gastroesophageal reflux disease (GERD) using nationally representative data from a National Sample Cohort of the National Health Insurance Service in Korea.The National Health Insurance Service-National Sample Cohort (NHIS-NSC) database from 2010 to 2012 was used in this study. GERD patients were defined as those diagnosed with specific tests, with screened medication, and without any other gastrointestinal diseases. Propensity score matching for age, sex, and economic status was applied to form a control cohort. Incidence rate, relative risks, Cox proportional-hazards modeling, and Kaplan-Meier analysis were applied to examine the differences between the GERD and control cohorts with regard to the risk of subsequent psychological disorders.The results showed that patients in the GERD cohort (n = 9503) had significantly higher risks of psychological disorders than those without GERD (adjusted hazard ratio [HR] 1.25, 95% confidence interval [CI] 1.07-1.47, P = .006). Specifically, the risk of depressive disorder was significantly higher for patients in the GERD cohort than in the control cohort (adjusted HR 1.41, 95% CI 1.04-1.91, P = .027). Kaplan-Meier analysis showed that the estimated probability of psychological disorders was significantly higher in the GERD cohort compared with the control cohort (log-rank test, P = .007).This study suggested that GERD may be a risk factor for subsequent psychological disorders, specifically, depressive disorder. The results of this study in GERD patients compared with non-GERD patients in Korea suggested that psychological disorders and GERD may be inter-related.
Collapse
Affiliation(s)
- Ye-Seul Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine
| | - Bo-Hyoung Jang
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine
| |
Collapse
|
17
|
Seo SI, Bang CS, Kang HS, Choi MH, Shin WG, Jang HJ, Kim JB, Baik KH, Kae SH, Kim HY. Evaluation of treatment pattern and symptom control in patients with gastroesophageal reflux disease: multihospital questionnaire survey on the current situation in Korea. Dis Esophagus 2017; 30:1-8. [PMID: 28859382 DOI: 10.1093/dote/dox034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/27/2017] [Indexed: 02/06/2023]
Abstract
Proton pump inhibitors (PPIs) are the most effective treatment for gastroesophageal reflux disease (GERD); however, a considerable number of patients fail to respond to PPI therapy and complain of nocturnal heartburn and sleep disturbance. The aims of this study are to evaluate the treatment pattern of GERD-related medications and their efficacy in relieving nocturnal heartburn. A total of 334 patients with GERD receiving PPI therapy within 6 months were enrolled in a multihospital questionnaire survey from January, 2014 to March, 2015. GERD symptoms and patients' satisfaction were assessed by patient questionnaires, and treatment patterns of GERD-related medications were assessed by investigators. Among the 334 patients, 95.8% used PPI once daily and 58.6% used a half-dose of PPI. The PPI treatment pattern was changed in 26.6% of all patients, of those, 54% of the patients doubled the PPI dose, and 29.2% of the patients switched to another PPI. Approximately 60.3% of all patients were prescribed more than three GERD-related medications. The overall satisfaction rate was 61.8%, and 32.2% of patients experienced nocturnal heartburn and sleep disturbance. In the extended-release PPI group, there were fewer nocturnal symptoms compared with the conventional PPI group (10% vs. 33.7%, respectively, P = 0.027). The use of more than three medications was inversely associated with patients' satisfaction (OR = 0.355, 95% CI; 0.197-0.642, P = 0.001). Most patients were prescribed adjunctive medications other than PPIs; however, patients' satisfaction was inversely associated with multiple drugs. Patients' satisfaction was superior in extended-release PPIs than conventional PPIs for the relief of nocturnal heartburn in Korean patients.
Collapse
Affiliation(s)
- S I Seo
- Department of Internal Medicine, Kangdong Sacred Heart Hospital
| | - C S Bang
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Gangwon-do
| | - H S Kang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital
| | - M H Choi
- Department of Internal Medicine, Dongtan Sacred Heart Hospital, Gyeonggi-do, Korea
| | - W G Shin
- Department of Internal Medicine, Kangdong Sacred Heart Hospital
| | - H J Jang
- Department of Internal Medicine, Dongtan Sacred Heart Hospital, Gyeonggi-do, Korea
| | - J B Kim
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul
| | - K H Baik
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Gangwon-do
| | - S H Kae
- Department of Internal Medicine, Dongtan Sacred Heart Hospital, Gyeonggi-do, Korea
| | - H Y Kim
- Department of Internal Medicine, Kangdong Sacred Heart Hospital
| |
Collapse
|
18
|
Jia L, Jiang SM, Liu J. Behavioral gastroenterology: An emerging system and new frontier of action. World J Gastroenterol 2017; 23:6059-6064. [PMID: 28970721 PMCID: PMC5597497 DOI: 10.3748/wjg.v23.i33.6059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/28/2017] [Accepted: 07/24/2017] [Indexed: 02/07/2023] Open
Abstract
Behavioral gastroenterology is a new interdisciplinary science that explores the influence of unhealthy lifestyles and psychological factors on the digestive system and addresses the prevention, diagnosis, treatment, and rehabilitation of digestive diseases. Moreover, the concept of whole-course intervention with a focus on disease prevention and a new model of integrated therapy based on alterations of lifestyle and psychology are being gradually established. This paradigm may substantively impact the prevention and treatment of digestive diseases.
Collapse
Affiliation(s)
- Lin Jia
- Department of Gastroenterology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong Province, China
- Department of Gastroenterology, The Second Affiliated Hospital, South China University of Technology, Guangzhou 510180, Guangdong Province, China
| | - Shu-Man Jiang
- Department of Gastroenterology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong Province, China
- Department of Gastroenterology, The Second Affiliated Hospital, South China University of Technology, Guangzhou 510180, Guangdong Province, China
| | - Jing Liu
- Department of Gastroenterology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong Province, China
- Department of Gastroenterology, The Second Affiliated Hospital, South China University of Technology, Guangzhou 510180, Guangdong Province, China
| |
Collapse
|
19
|
Oh JH. Gastroesophageal reflux disease: recent advances and its association with sleep. Ann N Y Acad Sci 2016; 1380:195-203. [DOI: 10.1111/nyas.13143] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 05/16/2016] [Accepted: 05/23/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Jung Hwan Oh
- Division of Gastroenterology, Department of Internal Medicine, St. Paul's Hospital, College of Medicine; The Catholic University of Korea; Seoul Republic of Korea
| |
Collapse
|
20
|
You ZH, Perng CL, Hu LY, Lu T, Chen PM, Yang AC, Tsai SJ, Huang YS, Chen HJ. Risk of psychiatric disorders following gastroesophageal reflux disease: a nationwide population-based cohort study. Eur J Intern Med 2015; 26:534-9. [PMID: 26021838 DOI: 10.1016/j.ejim.2015.05.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 05/04/2015] [Accepted: 05/12/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent studies have shown that the peripheral inflammation may cause the up-regulation of central nervous system inflammation and therefore possibly plays a vital role in the pathophysiology of subsequent psychiatric disorders. OBJECTIVE We explored the relationship between gastroesophageal reflux disease (GERD) and the subsequent development of psychiatric disorders including schizophrenia as well as bipolar, depressive, anxiety, and sleep disorders. METHODS We investigated patients who were diagnosed with GERD according to the data in the Taiwan National Health Insurance Research Database. A comparison cohort comprised patients without GERD who were matched according to age and sex. The incidence rate and the hazard ratios (HRs) of subsequent new-onset psychiatric disorders were calculated for both cohorts, based on the diagnoses of psychiatrists. RESULTS The GERD cohort consisted of 3813 patients, and the comparison cohort comprised 15,252 matched control patients without GERD. The risks of depressive disorder (HR=3.37, 95% confidence interval [CI]=2.49-4.57), anxiety disorder (HR=2.99, 95% CI=2.12-4.22), and sleep disorder (HR=2.69, 95% CI=1.83-3.94), were higher in the GERD cohort than in the comparison cohort. In addition, the incidence of newly diagnosed depressive, anxiety, and sleep disorders remained significantly increased in all of the stratified follow-up durations (0-1, ≥1year). CONCLUSIONS GERD may increase the risks of subsequent depressive, anxiety, and sleep disorders. These psychiatric disorders have a negative effect on people's quality of life. Clinicians should pay a particular attention to psychiatric comorbidities in GERD patients.
Collapse
Affiliation(s)
- Zi-Hong You
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Chia-Yi Branch, Chia-Yi, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chin-Lin Perng
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Li-Yu Hu
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ti Lu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Pan-Ming Chen
- Department of Psychiatry, Yuanshan & Su'ao Branch, Taipei Veterans General Hospital, Yilan, Taiwan
| | - Albert C Yang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Jen Tsai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Shin Huang
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hon-Jhe Chen
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
| |
Collapse
|
21
|
Kanaeda T, Ueda M, Arai M, Ishimura M, Kajiyama T, Hashiguchi N, Nakano M, Kondo Y, Hiranuma Y, Oyamada A, Yokosuka O, Kobayashi Y. Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test. J Arrhythm 2015; 31:364-70. [PMID: 26702316 PMCID: PMC4672080 DOI: 10.1016/j.joa.2015.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/25/2015] [Accepted: 06/08/2015] [Indexed: 01/30/2023] Open
Abstract
Background Pulmonary vein isolation (PVI) has become an important option for treating patients with atrial fibrillation (AF). Periesophageal nerve (PEN) injury after PVI causes pyloric spasms and gastric hypomotility. This study aimed to clarify the impact of PVI on gastric motility and assess the prevalence of gastric hypomotility after PVI. Methods Thirty consecutive patients with AF underwent PVI under luminal esophageal temperature (LET) monitoring. The 13C-acetate breath test was conducted before and after the procedure for all patients (PVI group). Gastric emptying was evaluated using the time to peak concentration of 13CO2 (Tmax). This test was also conducted in another 20 patients who underwent catheter ablation procedures other than PVI (control group). Results The number of patients with abnormal Tmax (≥75 min) increased from seven (23%) to 13 (43%) and from three (15%) to five (25%) after the procedure in the PVI group and control group, respectively. The mean Tmax was longer after PVI than before PVI (64±14 min vs. 57±15 min, p=0.006), whereas there was no significant difference before and after the procedure in the control group. However, no significant difference in ΔTmax was observed between the two groups (p=0.27). No patients suffered from symptomatic gastric hypomotility. Conclusions Asymptomatic gastric hypomotility occurred more often after PVI. However, the average impact of PVI on gastric motility was minimal.
Collapse
Affiliation(s)
- Tomonori Kanaeda
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Marehiko Ueda
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Makoto Arai
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masayuki Ishimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takatsugu Kajiyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naotaka Hashiguchi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masahiro Nakano
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Kondo
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasunori Hiranuma
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Arata Oyamada
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Osamu Yokosuka
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|
22
|
Kim SE, Kim N, Oh S, Kim HM, Park MI, Lee DH, Jung HC. Predictive factors of response to proton pump inhibitors in korean patients with gastroesophageal reflux disease. J Neurogastroenterol Motil 2015; 21:69-77. [PMID: 25537676 PMCID: PMC4288103 DOI: 10.5056/jnm14078] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 11/06/2014] [Accepted: 11/09/2014] [Indexed: 12/22/2022] Open
Abstract
Background/Aims Proton pump inhibitors (PPIs) are widely used in the treatment of gastroesophageal reflux disease (GERD). However, some patients fail to respond to PPI therapy. We investigated the efficacy of response to PPI therapy in patients with GERD symptoms. Methods A total of 179 subjects with GERD symptoms were prospectively enrolled and diagnosed with non-erosive reflux disease (NERD, n = 100) and erosive reflux disease (n = 79) by gastroscopy and Bernstein test and/or 24-hour esophageal pH testing. Subjects then received a standard dose of daily PPI therapy for at least 4 weeks. PPI therapy response was evaluated using questionnaires including questions about demographics, GERD symptoms, GERD impact scale, Epworth sleepiness scale, Pittsburgh sleep quality index (PSQI), hospital anxiety and depression scale, and abbreviated version of the World Health Organization quality of life scale. Results The rates of complete (≥ 80%), satisfactory (≥ 50%), partial (< 50%), and refractory response in the 179 participants were 41.3%, 30.2%, 18.4%, and 10.1%, respectively. Thus, overall response rate (complete and satisfactory responses) was 71.5%. Multivariate analysis showed body mass index < 23 kg/m2 (OR, 2.20; 95% CI, 1.12–4.34), higher total PSQI score (OR, 1.20; 95% CI, 1.05–1.35), history of psychotherapy or neuropsychiatric medication (OR, 2.44; 95% CI, 1.23–4.85), and NERD (OR, 3.30; 95% CI, 1.54–7.11) were associated with poor response to PPI therapy. Conclusions Psychological factors, sleep dysfunction, body mass index < 23 kg/m2, and NERD seem to be the major factors that lead to a poor response to PPI treatment in patients with GERD symptoms.
Collapse
Affiliation(s)
- Sung Eun Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea
| | - Sooyeon Oh
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Man Kim
- Departments of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea
| | - Hyun Chae Jung
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
23
|
Basoglu OK, Vardar R, Tasbakan MS, Ucar ZZ, Ayik S, Kose T, Bor S. Obstructive sleep apnea syndrome and gastroesophageal reflux disease: the importance of obesity and gender. Sleep Breath 2014; 19:585-92. [DOI: 10.1007/s11325-014-1051-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 08/12/2014] [Accepted: 08/18/2014] [Indexed: 02/02/2023]
|
24
|
You CR, Oh JH, Seo M, Lee HY, Joo H, Jung SH, Lee SH, Choi MG. Association Between Non-erosive Reflux Disease and High Risk of Obstructive Sleep Apnea in Korean Population. J Neurogastroenterol Motil 2014; 20:197-204. [PMID: 24840371 PMCID: PMC4015211 DOI: 10.5056/jnm.2014.20.2.197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 02/19/2014] [Accepted: 02/23/2014] [Indexed: 01/26/2023] Open
Abstract
Background/Aims Obstructive sleep apnea is becoming more important in gastroesophageal reflux disease (GERD) patients. This study investigated the prevalence of high risk for obstructive sleep apnea in GERD patients in comparison with that in healthy controls using the Berlin Questionnaire. We also investigated the risk factors for obstructive sleep apnea in GERD patients. Methods We enrolled 1,007 subjects: 776 healthy controls, 115 individuals with erosive reflux disease, and 116 with non-erosive reflux disease. GERD was diagnosed and classified using endoscopy and a reflux questionnaire. The Berlin Questionnaire was used to evaluate obstructive sleep apnea. Results More patients in the GERD group (28.2%) had higher risk for obstructive sleep apnea than healthy controls (20.4%, P = 0.036). More patients with non-erosive disease (32.8%) had higher risk for obstructive sleep apnea (OSA) than patients with erosive disease (20.9%) and controls (20.4%, P = 0.010). On multivariate analysis, non-erosive disease was a high risk factor for obstructive sleep apnea (odds ratio [OR], 1.82; P = 0.011). Age ≥ 55 years (OR, 1.83; P < 0.001) and a high body mass index (≥ 25 kg/m2) (OR, 2.76; P < 0.001) were also identified as risk factors. Nocturnal GERD was related to high risk for OSA in non-erosive disease patients (OR, 2.97; P = 0.019), but not in erosive disease patients. Conclusions High risk for OSA is more prevalent in GERD patients than in controls. Non-erosive reflux disease, age ≥ 55, and a high BMI are associated with high risk for OSA.
Collapse
Affiliation(s)
- Chan Ran You
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Jung Hwan Oh
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Minji Seo
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Hye Yeon Lee
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Hyonsoo Joo
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Sung Hoon Jung
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Sang Haak Lee
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Myung-Gyu Choi
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| |
Collapse
|