Dados do Trabalho

Título

Gastroesophageal Reflux Disease and Excessive Daytime Sleepiness - Causal Relationship: A Systematic Review

Introdução

Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder characterized by the reflux of stomach contents into the esophagus. On the other hand, Excessive Daytime Sleepiness (EDS) is defined as a person's inability to stay awake or alert during the main waking periods of the day. Recent research has highlighted a possible association between GERD and EDS. However, the prevalence of people with GERD developing EDS remains controversial.

Objetivo

To assess the prevalence of Excessive Daytime Sleepiness in patients with Gastroesophageal Reflux Disease

Métodos

This review followed the PRISMA 2020 protocol criteria. PubMed, PubMed Central, Web of Science, and EMBASE databases were searched until August 15, 2024. Research associating Excessive Daytime Sleepiness and Gastroesophageal Reflux Disease was included. The comparison group included people without GERD. The main outcome assessed was the prevalence of Excessive Daytime Sleepiness in patients with GERD.

Resultados

A total of 117 articles were selected through the search strategy, of which 7 met the inclusion and exclusion criteria, totaling a population of 8,334 patients. Wu et al. evaluated 94 patients with GERD, 37 of whom had EDS (measured by an Epworth >10). The study also showed a higher risk of EDS in patients with GERD compared to placebo [OR: 1.72 (1.08; 2.72); 95%CI p=0.022]. Guda et al. evaluated 94 patients who underwent polysomnography and a questionnaire on gastrointestinal symptoms. Patients with GERD symptoms had a higher apnea-hypopnea index (AHI) compared to those without symptoms (59.08 ±7.1 vs. 34.1 ±34.3 p=0.04). Hu et al. studied 73 people with a primary complaint of daytime sleepiness. The group with GERD had a higher percentage of patients who met the criteria for daytime sleepiness according to the Epworth Sleepiness Scale (ESS) than the group without GERD (48.8% vs. 3.1%, p <0.001). In addition, the absolute ESS score was higher in the GERD group (8.80 ±5.49 vs. 3.13 ±3.50, p <0.001).

Conclusões

This systematic review shows a significant association between GERD and EDS. The results from the analyzed studies indicate that individuals with GERD present a higher prevalence of EDS, suggesting a causal relationship between these conditions. This association can be explained by various factors, such as sleep fragmentation caused by nocturnal GERD symptoms and the occurrence of obstructive sleep apnea in patients presenting with GERD.

Palavras -chave

Excessive Daytime Sleepiness, Gastroesophageal Reflux Disease, Prevalence