# Incidence of Poor Sleep Quality and Its Predictors Among Adults With Upper Gastrointestinal Symptoms Visiting a Tertiary Care Hospital in Central India

## TL;DR

This study found that nearly 70% of adults with upper GI symptoms in India have poor sleep quality, influenced by factors like gender, tobacco use, and depression.

## Contribution

The study identifies novel predictors of poor sleep quality in Indian adults with upper GI symptoms, emphasizing non-GERD-related factors.

## Key findings

- 69.9% of participants had poor sleep quality (PSQI score >5).
- Female gender, tobacco use, being underweight, and moderate depression were significant predictors of poor sleep quality.
- GERD diagnosis was not an independent predictor of poor sleep quality after adjustment.

## Abstract

Background

Sleep disturbances are frequently associated with upper gastrointestinal (GI) symptoms, including gastroesophageal reflux disease (GERD). However, data from Indian settings remain limited. This study aimed to assess the proportion and predictors of poor sleep quality among adults with upper GI symptoms.

Methodology

A hospital-based, cross-sectional study was conducted at a tertiary care center in Bhopal, India, from November 2019 onwards. Adults presenting with upper GI symptoms were assessed using the GERD-Q, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Univariable and multivariable logistic regression analyses were used to identify predictors of poor sleep quality (PSQI score >5).

Results

Among 500 participants (mean age = 38.1 ± 14.7 years; 62.6% male), 69.9% (306/500) had poor sleep quality. Female gender (adjusted odds ratio (aOR) = 2.07, p = 0.017), tobacco use (aOR = 2.47, p = 0.003), being underweight (body mass index <18.5 kg/m²; aOR = 2.43, p = 0.043), and moderate depression (PHQ-9 score of 10-14; aOR = 2.64, p = 0.033) were significant predictors (N = 306/500). While GERD symptoms were common, GERD diagnosis (GERD-Q score ≥8) was not an independent predictor after adjustment.

Conclusions

Poor sleep quality is prevalent among patients with upper GI symptoms and is influenced by gender, lifestyle, nutritional status, and psychological well-being rather than GERD alone. Integrated care approaches addressing these factors are essential for improving sleep health in this population.