| 摘要: | 研究目的:近年來國人越來越重視生活品質，其中睡眠以及飲食就占了生活中的大部分。隨著自我的健康意識提升也越來越重視自己的生活習慣是否正常，進而去做改變以及調整。
例如睡眠時間的長短、深眠、淺眠抑或是長期性的失眠，導致的失眠、淺眠此類的原因有很多。可能與飲食習慣、生活作息、工作時間以及壓力都有關係。
為提升國人重視的生活品質以及自我的健康意識，讓生活過得更好更健康，因此，本研究期望能找出睡眠障礙與胃食道逆流此兩疾病之間的相關性，以利提供相關資料供給相關單位給予相關人員作為一個參考的依據。
研究方法:本研究使用臺灣全民健保資料庫進行為期5年的全國性人口世代研究。以2001年至2005年篩選出278,967名睡眠障礙患者，並根據性別、年齡和共病指標以1:4的比例配對出1,115,868名對照組，以探討有無睡眠障礙患者5年內是否發生胃食道逆流，運用Cox比例風險模式探討睡眠障礙與發生胃食道逆流之縱向風險關係。
研究結果: 在納入本研究的278,967名患者中，睡眠障礙患者發生胃食道逆流症的風險高於無睡眠障礙患者(校正風險比=15.695，95%信賴區間為12.936-19.001，P<0.0001)。此外，男性比女性發生胃食道逆流症的風險高(校正風險比=1.331，95%信賴區間為1.202-1.473，P<0.0001)。青年(21至40歲)也比中年(41至60歲，校正風險比=0.752，95%信賴區間為0.658-0.859，P<0.0001)及老年族群(61至80歲，校正風險比=0.538，95%信賴區間為0.456-0.636，P<0.0001)發生胃食道逆流症的風險高。在基於隨訪期(追蹤一年及五年)的亞組分析中，睡眠障礙與胃食道逆流症的相關性仍然呈現統計上的顯著相關(均為P<0.0001)。
結論: 本研究顯示睡眠障礙患者比起一般人具有較高的風險罹患胃食道逆流症，臨床醫師應該仔細留意這層關係並深入研究睡眠障礙患者胃食道逆流症發生的可能性。
INTRODUCTION: In recent years, Compatriot pay more and more attention to the quality of life, among which sleep and diet account for most of their lives. With the improvement of self-health awareness, more and more attention is paid to whether their living habits are normal, and then to make changes and adjustments.
For example, the length of sleep time, deep sleep, light sleep or long-term insomnia, there are many reasons for insomnia and light sleep. It may be related to eating habits, daily routine, working hours and stress.
In order to improve the quality of life that Chinese people value and their own health awareness, so that they can live a better and healthier life.
Therefore, this study expects to find out the correlation between sleep disturbance and gastroesophageal reflux disease (GERD), so as to provide relevant information to relevant units and provide relevant personnel as a reference basis.
METHODS: Data from National Health Insurance Research Database (NHIRD) were analyzed to compile (1) 278,967 patients newly diagnosed with Sleep disorder symptoms between 2001 and 2005 as well as (2) a comparison cohort of 1,115,868 matched non- Sleep disorder symptoms enrollees (according to sex, age and comorbidity, control group patients were matched in a ratio of one to four). Each patients was followed for 5 years to identify cases in which GERD subsequently developed. Cox proportional hazards regressions were used to calculate adjusted hazard ratios (HRs).
RESULTS: Among the 278,967 patients enrolled in this study, The hazard ratio (HR) for gastroesophageal reflux disease was 15.695 times higher (95% confidence interval [C.I.]=12.936-19.001;P<0.0001) in this sleep disorder symptoms cohort than in the non-sleep disorder symptoms cohort after adjustment for potential confounders. Furthermore, the risk of gastroesophageal reflux disease was significant in men (adjusted HR=1.331 C.I.=1.202-1.473). Youth-aged (21-40 years) patients had a particularly high risk than middle-aged (41-60 years; adjusted HR=0.752 C.I.=0.658-0.859;P<0.0001) and older (61-80 years; adjusted HR=0.538 C.I.=0.456-0.636;P<0.0001). In subgroup analyses based on follow-up periods (i.e. 1 and 5years), the association between sleep disorder symptoms and gastroesophageal reflux disease remained significant (all P<0.0001).
CONCLUSIONS: This study shows that patients with sleep disorder symptoms have a higher risk of suffering from gastroesophageal reflux disease than general population.
Clinicians should pay close attention to this relationship and timely evaluate this group of patients, and carefully study the possibility of gastroesophageal reflux disease in patients with sleep disorder symptoms. |
