A Population-Based Study of Gastroesophageal Reflux Disease and Sleep Problems in Elderly Twins

Abstract

Background & AimsPrevious studies indicate an association between sleep problems and gastroesophageal reflux disease (GERD). Although both these conditions separately have moderate heritabilities, confounding by genetic factors has not previously been taken into account. This study aimed to reveal the association between sleep problems and GERD, while adjusting for heredity and other potential confounding factors.MethodsThis cross-sectional population-based study included all 8,014 same-sexed twins of at least 65 years of age and born in Sweden between 1886 and 1958, who participated in telephone interviews in 1998–2002. Three logistic regression models were used 1) external control analysis, 2) within-pair co-twin analysis with dizygotic (DZ) twin pairs discordant for GERD, and 3) within-pair co-twin analysis with monozygotic (MZ) twin pairs discordant for GERD. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and adjusted for established risk factors for GERD, i.e. sex, age, body mass index (BMI), tobacco smoking, and educational level.ResultsA dose-response association was identified between increasing levels of sleep problems and GERD in the external control analysis. Individuals who often experienced sleep problems had a two-fold increased occurrence of GERD compared to those who seldom had sleep problems (OR 2.0, 95% CI 1.8–2.4). The corresponding association was of similar strength in the co-twin analysis including 356 DZ pairs (OR 2.2, 95% CI 1.6–3.4), and in the co-twin analysis including 210 MZ pairs (OR 1.5, 95% CI 0.9–2.7).ConclusionA dose-dependent association between sleep problems and GERD remains after taking heredity and other known risk factors for GERD into account.

Sleep disorders in the elderly: a growing challenge

“…A detailed review on the alterations in intercellular communication, cellular senescence, mitochondrial dysfunction, deregulated nutrient sensing, loss of proteostasis, epigenetic alterations, and genomic instability provides insights into several interlinked components that are considered hallmarks of the ageing process . A progressive loss of physiological integrity as well as impaired and deteriorated body functioning increase the risk for metabolic disorders, cardiovascular diseases, neurodegenerative diseases, and even cancer . Telomeres are the chromosomal regions that are particularly susceptible to age‐related deterioration .…”

“…Common medical problems such as hypertension, diabetes mellitus, renal failure, respiratory diseases (e.g. asthma), immune disorders, and gastroesophageal reflux disease are all associated with sleep problems …”

“…35 A progressive loss of physiological integrity as well as impaired and deteriorated body functioning increase the risk for metabolic disorders, cardiovascular diseases, neurodegenerative diseases, and even cancer. 19,[43][44][45][46][47][48][49][50] Telomeres are the chromosomal regions that are particularly susceptible to age-related deterioration. 51 Insomnia in older adults (aged 70-88 years) is associated with shorter telomere length in peripheral blood mononuclear cells.…”

“…asthma), immune disorders, and gastroesophageal reflux disease are all associated with sleep problems. 45,46,49,50…”

Hospital and Surgeon Volume in Relation to Survival After Esophageal Cancer Surgery in a Population-Based Study

“…Still five years postoperatively, patients with major postoperative complications reported more problems with reflux and sleep disturbance. Reflux has been shown to be associated with sleep problems, 186 although the direction of this association is complex and not fully understood. 187…”