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Gastroesophageal Reflux and Sleep Disturbances: A Bidirectional Association in a Population-Based Cohort Study, The HUNT Study.

STUDY OBJECTIVES
To investigate the potentially bidirectional association between gastroesophageal reflux symptoms (GERS) and sleep disturbances/ insomnia disorders.


METHODS
We assessed the incidence of new-onset of self-reported GERS, sleep disturbances, and insomnia disorders in a population-based longitudinal cohort study (HUNT), performed in Nord-Trøndelag County, Norway. Modified Poisson regression was used to estimate risk ratios (RRs) with 95% confidence intervals (CIs), adjusted for sex, age, body mass index, tobacco smoking, educational level, anxiety, and depression.


RESULTS
The study cohort included the 25,844 participants of the HUNT study who responded to health questionnaires in both 1995-1997 and 2006-2009. New-onset GERS, sleep disturbances, and insomnia disorders was reported in 396 (2%), 2,598 (16%), and 497 (3%) participants, respectively. Persistent sleep disturbances were associated with new-onset GERS (RR: 2.70, 95% CI: 1.93-3.76), persistent insomnia disorders were associated with new-onset GERS (RR: 3.42; 95% CI: 1.83-6.39) and persistent GERS was associated with new-onset sleep disturbances (RR: 1.41; 95% CI: 1.14-1.75).


CONCLUSIONS
Sleep disturbances and GERS seem to be bidirectionally associated, and sleep disturbances seem to be a stronger risk factor for GERS than the reverse.