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-Trondelag 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.