Frequency, duration of gastroesophageal reflux symptoms linked to poor sleep in women
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Key takeaways:
- More than 16% of women with gastroesophageal reflux symptoms developed poor sleep quality in 4 years.
- The risk for poor sleep quality was significantly higher in those with symptoms at least twice a week.
More frequent and longer duration of gastroesophageal reflux symptoms correlated with greater risk for poor sleep quality in women, highlighting the importance of treating patients with GERD, according to data in JAMA Network Open.
“Approximately 20% of the U.S. population experiences gastroesophageal reflux (GER) symptoms at least once a week, and the worldwide prevalence of GERD has been increasing,” Jane Ha, MD, of the clinical and translational epidemiology unit at Massachusetts General Hospital and Harvard Medical School, and colleagues wrote. “Growing evidence supports an association between GER symptoms and poor sleep quality. However, several previous studies are limited by a cross-sectional design and a lack of data on frequency and duration of symptoms.”
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In a prospective cohort study, Ha and colleagues analyzed data collected from 48,536 women (median age, 59 years; 95.2% white) with GER symptoms enrolled in the Nurses’ Health Study II. Participants reported frequency and duration of symptoms of acid reflux or heartburn beginning June 2005 and every 4 years thereafter with a final follow-up in June 2019.
Using the modified Pittsburgh Sleep Quality Index, researchers evaluated difficulty falling asleep, restless sleep, daytime sleepiness, sleep disturbance and sleep duration, each with a score of 0 to 3 (more severe); an overall score of 7 or more constituted poor sleep quality.
Study results showed 15.9% of participants reported GER symptoms at least twice per week at baseline and 16.3% developed poor sleep quality during 4 years of follow-up. The mean score of overall sleep quality was 4.7 in those who had GER symptoms less than once per month vs. 5.6 in those with symptoms at least twice a week.
Further, compared with women who experienced GER symptoms less than once a month, multivariate analysis showed the relative risk (RR) for poor sleep quality was 1.15 (95% CI, 1.06-1.25) for those with symptoms up to three times per month, 1.31 (95% CI, 1.24-1.38) for those with symptoms once per week and 1.53 (95% CI, 1.45-1.62) for those with symptoms two or more times per week. Women who had GER symptoms at least once a week for more than 7 years had an RR of 1.36 (95% CI, 1.3-1.43).
For each sleep component, the RRs for GER symptoms at least twice a week compared with no symptoms were 1.49 (95% CI, 1.39-1.58) for difficulty falling asleep, 1.47 (95% CI, 1.39-1.56) for excessive daytime sleepiness and 1.44 (95% CI, 1.36-1.53) for restlessness. Experiencing more frequent symptoms was significantly associated with an increased risk for poor sleep quality across individual components.
“GER symptoms may be associated with risk of poor sleep quality among women,” Ha and colleagues concluded. “Because poor sleep quality has been associated with incidence of chronic disease and mortality, these results further highlight the importance of promptly assessing and effectively treating patients with GERD.”
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