title: Gastrointestinal symptoms negatively impact on sleep quality among obese individuals: a population-based study.
abstract: BACKGROUND
  Reduced sleep quality has been linked to obesity; however, no studies have assessed the impact of gastrointestinal (GI) symptoms on sleep quality among obese individuals. This study aims to determine the role of gastrointestinal symptoms on sleep among obese individuals in a community-based sample.
  
  
  METHODS
  A validated questionnaire was sent to 5000 randomly selected subjects in Western Sydney, Australia. Assessed were five GI symptoms that might wake individuals from sleep (abdominal pain, diarrhea, chest pain, acid regurgitation, and heartburn). Sleep quality was measured using the validated Pittsburgh Sleep Quality Index (PSQI). Additional measures included socioeconomic status (SES) and body mass index (BMI).
  
  
  RESULTS
  The response rate was 60 %. There were 647 (25.13 %) obese individuals. Prevalence estimates for general quality of sleep were reported as very good (18.51 %), fairly good (53.19 %), fairly bad (20.68 %), and very bad (7.62 %). Obese individuals reported less hours of actual sleep than nonobese individuals (OR = 0.87; 95 % CI 0.81-0.94). Quality of sleep was worse for obese compared to nonobese individuals (OR = 1.25; 95 % CI 1.12-1.40). Univariate analysis found that all GI symptoms were more likely to wake obese people from their sleep; however, only two GI symptoms (chest pain: OR = 1.60; 95 % CI 1.25-2.04) and (acid regurgitation: OR = 1.27; 95 % CI 1.05-1.53) were independent predictors of sleep disturbance.
  
  
  CONCLUSIONS
  Gastrointestinal symptoms did not predict waking in nonobese individuals. Chest pain and acid regurgitation are major GI symptoms associated with waking obese individuals from sleep. Overall, obese individuals have a worse quality of sleep compared to nonobese individuals.
authors.affiliation: School of Public Health, The University of Sydney, Sydney, NSW, Australia. eslickg@med.usyd.edu.au.|Department of Medicine, Nepean Hospital, The University of Sydney, Penrith, NSW, Australia. eslickg@med.usyd.edu.au.|Department of Surgery, The Whiteley-Martin Research Centre, Nepean Hospital, Clinical Building, Level 3, P.O. Box 63, Penrith, NSW, 2751, Australia. eslickg@med.usyd.edu.au.
authors.forename: Guy D
authors.initials: GD
authors.lastname: Eslick
authors.affiliation: Department of Medicine, Nepean Hospital, The University of Sydney, Penrith, NSW, Australia.|Faculty of Health, The University of Newcastle, Callaghan, NSW, Australia.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D009765:Obesity / Q000150:complications* / Q000453:epidemiology*; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014851:Wakefulness; D055815:Young Adult
keywords: Gastrointestinal symptoms; Obesity; Quality of life; Sleep