title: A population-based study showing an association between gastroesophageal reflux disease and sleep problems.
abstract: OBJECTIVE
  Gastroesophageal 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  In 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.
  
  
  CONCLUSIONS
  A large population-based study indicated a link between sleep problems and gastroesophageal reflux disease that might be bidirectional.
authors.affiliation: Unit of Esophageal and Gastric Research (ESOGAR), Department of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden. Catarina.Jansson@ki.se
authors.forename: Catarina
authors.initials: C
authors.lastname: Jansson
authors.forename: Helena
authors.initials: H
authors.lastname: Nordenstedt
authors.forename: Mari-Ann
authors.initials: MA
authors.lastname: Wallander
authors.forename: Saga
authors.initials: S
authors.lastname: Johansson
authors.forename: Roar
authors.initials: R
authors.lastname: Johnsen
authors.forename: Kristian
authors.initials: K
authors.lastname: Hveem
authors.forename: Jesper
authors.initials: J
authors.lastname: Lagergren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D016017:Odds Ratio; D011159:Population Surveillance; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult