The aim: The work is aimed to study the formation mechanisms of sleep disturbances with GERD based on the determination of melatonin and serotonin indicators in the blood, psychosomatic status and quality of sleep, motor-secretory function of the esophagus and stomach in young people. Materials and methods: All 63 patients were with non-erosive GERD and insomnia. Among them, 32 with inhibitory personality type and 31 with excitable personality type. The control group is 25 people. Questionnaires were used to determine the quality of sleep, quality of life, state of the nervous system, ultrasound, stomach acidity, level of melatonin and serotonin. Results: In patients with inhibitory personality type, depressive disorders, lower sleep quality and quality of life were more pronounced, and in patients with excitable type, increased levels of reactive and personal anxiety and pronounced motor-secretory disorders. Conclusions: Psychosomatic disorders in GERD have a significant impact not only on the quality of sleep, quality of life, the level of melatonin and serotonin, the regulation of the secretory and motor functions of the stomach, but they are one of the links in the pathogenetic mechanism of the formation of both GERD and insomnia with it.

The aim of the study: to optimize diagnostics and treatment of comorbid gastroesophageal reflux disease (GERD) and concomitant neurocirculatory dystonia (NCD) with insomnia among young people by studying autonomic dysfunction and mechanisms of its realization. Methods. The study was conducted in three groups of patients, homogeneous by gender and age. The first group included patients with GERD and insomnia, the second group counted those with NCD and insomnia, and the third group consisted of GERD with NCD and insomnia. We studied the quality of life (SF-36), quality of sleep (PSQI), the presence and severity of depression (PHQ-9), psychosomatic condition (Spielberger-Khanin scale), and determined the presence and severity of autonomic dysfunction syndrome (Wayne questionnaire), acidity of the stomach, ultrasound examination of the esophagus and stomach. Results. The first group revealed sympathicotonia and increase of gastric juice aggression (in the stomach body 0.89±0.05) and reactive (47.2 points) and personal anxiety (52.7 points), which suggests the advisability of use PPI (omeprazole 20 mg 2 times a day for 5 weeks), and melatonin 3 mg per night during 3 weeks. The second group showed parasympathicotonia predominant, a more pronounced decrease in vitality scale (31.5±4.2), and a moderate increase in indicators of reactive (44.0 points) and personal anxiety (46.5 points), which suggests the advisability of use 3 mg of melatonin per night during 3 weeks. The third group demonstrated predominance of parasympathicotonia, motor disorders, a decrease in alkalizing function of antrum (5.4±0.17), depression (81.8 %), and the greatest decrease in indicators of sleep quality (11.7) and quality of life, which suggests the advisability of use PPI (omeprazole 20 mg 2 times per day during 5 weeks), with prokinetics (domperidone 10 mg 3 times per day during 5 weeks), and melatonin 3 mg per night during 3 weeks. Conclusions. Autonomic dysfunction has a key influence on the main pathogenetic factors in the formation of both GERD and NCD and insomnia, and the type of autonomic tone determines the features of the clinical course of both isolated and combined pathology.

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