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Meta-Analysis
. 2024 Apr 16:12:e17202.
doi: 10.7717/peerj.17202. eCollection 2024.

Bidirectional correlation between gastroesophageal reflux disease and sleep problems: a systematic review and meta-analysis

Xiaolong Tan  1 , Shasha Wang  2 , Fengjie Wu  1 , Jun Zhu  1
Affiliations
Meta-Analysis

Bidirectional correlation between gastroesophageal reflux disease and sleep problems: a systematic review and meta-analysis

Xiaolong Tan et al. PeerJ. .

Abstract

Objectives: Gastroesophageal reflux disease (GERD) and sleep problems are highly prevalent among the general population. Both them are associated with a variety of psychiatric disorders such as depression and anxiety, which is highlighting an underexplored connection between them. This meta-analysis aims to explore the association between sleep problems and GERD.

Methods: We conducted a comprehensive search on PubMed, Cochrane Library, Embase, and Web of Science, using Medical Subject Headings (MeSH) and keywords, covering articles from the inception of the databases until August 2023. Stata statistical software, version 14.0, was utilized for all statistical analyses. A fixed-effects model was applied when p > 0.1 and I2 ≤ 50%, while a random-effects model was employed for high heterogeneity (p < 0.1 and I2 > 50%). Funnel plots and Egger's test were used to assess publication bias.

Results: Involving 22 studies, our meta-analysis revealed that insomnia, sleep disturbance, or short sleep duration significantly increased the risk of GERD (OR = 2.02, 95% CI [1.64-2.49], p < 0.001; I2 = 66.4%; OR = 1.98, 95% CI [1.58-2.50], p < 0.001, I2 = 50.1%; OR = 2.66, 95% CI [2.02-3.15], p < 0.001; I2 = 62.5%, respectively). GERD was associated with an elevated risk of poor sleep quality (OR = 1.47, 95% CI [1.47-1.79], p < 0.001, I2 = 72.4%), sleep disturbance (OR = 1.47, 95% CI [1.24-1.74], p < 0.001, I2 = 71.6%), or short sleep duration (OR = 1.17, 95% CI [1.12-1.21], p < 0.001, I2 = 0).

Conclusion: This meta-analysis establishes a bidirectional relationship between four distinct types of sleep problems and GERD. The findings offer insights for the development of innovative approaches in the treatment of both GERD and sleep problems.

Keywords: GERD; Gastroesophageal reflux disease; Insomnia; Poor sleep quality; Short sleep duration; Sleep disturbance.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Studies screening process.
Figure 2
Figure 2. Meta-analysis of the risk of GERD associated with sleep problems.
(1) Meta-analysis of the risk of GERD associated with insomnia. (2) Meta-analysis of the risk of GERD associated with sleep disturbance. (3) Meta-analysis of the risk of GERD associated with short sleep duration (Jansson et al., 2009; Lindam et al., 2012, 2016; Zhang et al., 2012b; Fass et al., 2005; Ju et al., 2013; Zhang et al., 2012a; Chang et al., 2021; Emilsson et al., 2022; Ahmed et al., 2020; Yadegarfar et al., 2018).
Figure 3
Figure 3. Meta-analysis of the risk of sleep problems associated with GERD.
(1) Meta-analysis of the risk of poor sleep quality associated with GERD. (2) Meta-analysis of the risk of sleep disturbance associated with GERD. (3) Meta-analysis of the risk of short sleep duration associated with GERD (Horsley-Silva et al., 2019; Ha et al., 2023; Chen et al., 2009; Hyun, Baek & Lee, 2019; Wallander et al., 2007; You et al., 2015; Cremonini et al., 2009; Okuyama et al., 2017; Lei et al., 2019; Cadiot et al., 2011; Ha et al., 2023; Chen et al., 2009; Murase et al., 2014).
Figure 4
Figure 4. Publication bias of meta-analysis of the risk of GERD associated with insomnia.
See this image and copyright information in PMC

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