Poor Sleep Linked with Peptic Ulcer Disease Recurrence

Patients experiencing poor sleep quality may be at greater risk for peptic ulcer disease (PUD) recurrence, according to a recent study.

“Poor sleep quality and peptic ulcer disease (PUD) are both major public health problems affecting physical and psychological well-being of older adults,” according to the study by Boye Fang, PhD, from the University of Hong Kong, China, and colleagues.

This study was designed to look at the effect of subjective and objective sleep quality on subsequent recurrence of PUD in older patients after Helicobacter pylori (H. pylori) eradication. To do that, the researchers included 1,689 Chinese patients aged 55 or older from eight grade A hospitals in China. All patients had H. pylori-infected PUD and were recruited between January 2011 and October 2014. Follow-up of up to 36 months was completed in 1,420 of these patients.

After 36-month follow-up, the cumulative PUD recurrence rate was 8.3%, with an annual recurrence rate of 2.8%. The majority of patients had a single ulcer recurring at the same sight as the original ulcer.

Multivariable analysis showed that poorer subjective sleep quality was associated with an increased risk for PUD recurrence (hazard ratio [HR] = 1.895; 95% CI, 1.008-3.327).

“Our findings that poor perceived sleep quality predicts subsequent PUD recurrence partially support previous results that older patients who reported poor sleep quality were more likely to have PUD, although they did not further ascertain the link between perceived sleep quality and PUD recurrence,” the researchers noted.

A greater number of awakenings (HR = 1.697; 95% CI, 1.168-2.665) and longer sleep onset latency (HR = 1.558; 95% CI, 1.156-2.278) were associated with increased odds of PUD recurrence.

Looking at objective sleep quality, the study showed that a longer total sleep time protected patients from recurrence (HR = 0.768; 95% CI, 0.699-0.885).

“The effect of both subjective and objective poor sleep quality on subsequent PUD recurrence suggests the importance of including sleep assessment as an integral component while dealing with patients with previous ulcers,” the researchers wrote. “Meanwhile, proper sleep treatments should be provided for these patients.”