title: Gastroesophageal reflux disease and sleep quality in a Chinese population.
abstract: OBJECTIVE
  Although evidence suggests that gastroesophageal reflux disease (GERD) may interrupt sleep, the effects of symptomatic and endoscopically diagnosed GERD remain elusive because the patient population is heterogeneous. Accordingly, we designed a cross-sectional study to assess their association.
  
  
  METHODS
  Consecutive participants in a routine health examination were enrolled. Definition and severity of erosive esophagitis were assessed using the Los Angeles classification system. Demographic data, reflux symptoms, sleep quality and duration, exercise amount, alcohol consumption, and smoking habits were recorded. Factors affecting sleep quality and sleep duration were revealed by a polytomous logistic regression analysis.
  
  
  RESULTS
  A total of 3663 participants were recruited. Subjects with reflux symptoms, female gender, higher body mass index, and regular use of hypnotics had poorer sleep quality. Exercise was associated with better sleep quality. Either symptomatically or endoscopically, GERD did not disturb sleep duration. Among the 3158 asymptomatic patients, those with erosive esophagitis were more likely to have poor sleep quality. The risk increased with the severity of erosive changes (p = 0.03).
  
  
  CONCLUSIONS
  The present study highlights the adverse effect of gastroesophageal reflux on sleep, even in the absence of reflux symptoms. This finding has therapeutic implications in patients with silent erosive disease, and future trials are warranted.
authors.affiliation: Departments of Internal Medicine and Diagnostics and Therapeutics, College of Medicine, National Taiwan University, Taipei Taiwan.
authors.forename: Mei-Jyh
authors.initials: MJ
authors.lastname: Chen
authors.forename: Ming-Shiang
authors.initials: MS
authors.lastname: Wu
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
authors.forename: Kuang-Yi
authors.initials: KY
authors.lastname: Chang
authors.forename: Han-Mo
authors.initials: HM
authors.lastname: Chiu
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Liao
authors.forename: Chien-Chuan
authors.initials: CC
authors.lastname: Chen
authors.forename: Yo-Ping
authors.initials: YP
authors.lastname: Lai
authors.forename: Hsiu-Po
authors.initials: HP
authors.lastname: Wang
authors.forename: Yi-Chia
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004941:Esophagitis / Q000145:classification* / Q000150:complications / Q000473:pathology; D004945:Esophagoscopy / Q000009:adverse effects; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000009:adverse effects; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome