The Relationship between Erosive Esophagitis and Sleep Issues in Working-Aged Koreans

Studies have demonstrated that gastroesophageal reflux disease has an unfavorable effect on sleep. However, it is largely unknown whether erosive esophagitis (EE) is associated with sleep issues.

Study participants were 335,883 Korean adults who underwent upper endoscopy and completed the Pittsburgh Sleep Quality Index (PSQI) as part of a health check-up. Study participants were divided into an EE group and a non-EE group. Multivariable adjusted logistic regression analysis was used in calculating the odds ratio (OR) and 95% confidence interval (CI) (adjusted OR [95% CI]) for poor sleep quality, long sleep induction time, interrupted sleep, sleep pill use, and short sleep duration in the two groups. Subgroup analysis was conducted after stratifying the EE group patients on the basis of the extent of EE (Los Angeles classification [LA]-A, LA-B/C/D).

While the prevalence of EE was higher in men (11.1%) than women (1.8%), the mean PSQI score was higher in women (5.3±2.7) than in men (4.9±2.3). In men, EE was associated with poor sleep quality (adjusted OR, 1.04; 95% CI, 1.01 to 1.08), long sleep induction time (adjusted OR, 1.10; 95% CI, 1.03 to 1.18), and interrupted sleep (adjusted OR, 1.11; 95% CI, 1.04 to 1.19). Subgroup analysis showed that LA-A was significantly associated with poor sleep quality (adjusted OR, 1.04; 95% CI, 1.01 to 1.08), long sleep induction time (adjusted OR, 1.11; 95% CI, 1.03 to 1.19), and interrupted sleep (adjusted OR, 1.12; 95% CI, 1.04 to 1.20) in men. In contrast, women failed to show a significant association between EE and sleep issues.

EE was associated with a modest increase in the likelihood of poor sleep quality, long sleep induction time, and interrupted sleep among men.