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Background & AimsGastroesophageal reflux disease and sleep problems are common health problems in Western nations. It is important to clarify the association between sleep and gastroesophageal reflux disease, but only a few population-based studies have been conducted. MethodsA population-based, cross-sectional, case-control study was based on 2 large health surveys performed in the Norwegian county Nord-Trondelag in 1984–1986 and 1995–1997. Gastroesophageal reflux disease was assessed in the second survey, which included 65,333 participants (70% of the county's adult population). The 3153 persons who reported severe reflux symptoms constituted the cases, and the 40,210 persons without reflux symptoms constituted the controls. Data on insomnia, sleep problems, and several potential confounders were collected in questionnaires. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by using unconditional logistic regression in crude and multivariable models. ResultsIn models adjusted for age, sex, tobacco smoking, obesity, and socioeconomic status, positive associations were observed between presence of insomnia (OR, 3.2; 95% CI, 2.7–3.7), sleeplessness (OR, 3.3; 95% CI, 2.9–3.8), problems falling asleep (OR, 3.1; 95% CI, 2.5–3.8), and risk of gastroesophageal reflux disease. These associations were attenuated after further adjustments for anxiety, depression, myocardial infarction, angina pectoris, stroke, and gastrointestinal symptoms, but they remained statistically significant. ConclusionsA large population-based study indicated a link between sleep problems and gastroesophageal reflux disease that might be bidirectional. Abbreviations used in this paper: BMI, body mass index, CI, confidence interval, DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, GERD, gastroesophageal reflux disease, HUNT, Helseundersokelsen i Nord-Trondelag, OR, odds ratio, SES, socioeconomic status, WHO, World Health Organization ⁎ Unit of Esophageal and Gastric Research (ESOGAR), Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden ‡ AstraZeneca R & D, Mölndal, Sweden § Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden ∥ Institute of Medicine, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden ¶ Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway # HUNT Research Centre, Verdal, Norway
Conflicts of interest The authors disclose no conflicts. Funding This study was supported by AstraZeneca R&D, Mölndal, Sweden. PII: S1542-3565(09)00214-6 doi:10.1016/j.cgh.2009.03.007 © 2009 AGA Institute. Published by Elsevier Inc. All rights reserved.
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ABSTRACT
A Population-Based Study Showing an Association Between Gastroesophageal Reflux Disease and Sleep Problems