Association Between Reflux Symptom Severity and Sleep Quality in Patients With Laryngopharyngeal Reflux: A Cross-Sectional Observational Study

喉咽反流患者反流症状严重程度与睡眠质量的关系:一项横断面观察研究

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Abstract

OBJECTIVE: This study aimed to investigate the relationship between reflux symptom severity and sleep quality in patients diagnosed with laryngopharyngeal reflux (LPR). METHODS: This cross-sectional observational study included 153 patients aged 20-75 years who were diagnosed with LPR at our clinic. Reflux symptom severity was measured using the Reflux Symptom Index (RSI), and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Demographic characteristics, RSI scores, and PSQI total and subcomponent scores were analyzed. Correlations between the RSI and PSQI total and subcomponent scores were evaluated using Spearman's correlation test. Additionally, a multiple linear regression analysis was performed to evaluate the independent association between RSI and PSQI scores while adjusting for age. RESULTS: The study included 153 patients (84 females, 69 males) with a mean age of 49.1 ± 12.8 years. The mean RSI total score was 20.7 ± 4.6, and the mean PSQI total score was 6.8 ± 1.5. RSI and PSQI were weakly but significantly correlated (r = 0.37); age and RSI showed a moderate to strong correlation (r = 0.59); and age and PSQI were weakly correlated (r = 0.23) (all p < 0.05). Among the PSQI subcomponents, the strongest correlations with the RSI were observed for daytime dysfunction (r = 0.34) and sleep efficiency (r = 0.31). No significant differences in the RSI or PSQI scores were found between the sexes. In the multivariate model, the RSI total score remained a significant independent predictor of poor sleep quality (β = 0.36, p < 0.001) whereas age was not a significant predictor. CONCLUSION: LPR symptom severity was significantly associated with impaired sleep quality, particularly in the domains of sleep efficiency and daytime functioning. Routine assessment of sleep quality in patients with LPR may enhance the treatment outcomes and patient satisfaction.

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