Sleep disorders, its mechanisms, and correction in patients with gastroesophageal reflux disease and neurocirculatory dystonia

I.O. Balaklytska

Kharkiv Medical Akademy of Postgraduate Education

This article addresses the issue of the part of melatonin—serotonin system in the mechanisms of formation of insomnia with GERD accompanied by NCD. We conducted a study of four groups of patients suffering from GERD with insomnia and from GERD accompanied by NCD with insomnia. Two groups have got melatoninbased medication in addition to the standard therapy. We studied sleep quality using PSQI questionnaire, motor-secretory changes of esophagus and stomach, level of melatonin and serotonin in blood serum before and after the treatment. We found out that patients with GERD with insomnia and with GERD accompanied by NCD with insomnia have significant changes in the level of both melatonin and serotonin, whereas in patients with comorbid course these changes are more considerable. We established a correlation between noticeability of GERD clinical features, sleep quality, motor-secretory disorders, and level of melatonin and serotonin. Adding melatonin medication to the standard treatment scheme for patients suffering from GERD with insomnia and from GERD accompanied by NCD with insomnia facilitates significant improvement of sleep quality, motorsecretory indicators, and level of melatonin and serotonin in blood serum, as a result advancing remission.

Key Words: melatonin, serotonin, gastroesophageal reflux disease, insomnia, neurocirculatory dystonia.

https://dx.doi.org/10.15407/internalmed2020.01.099

Download.PDF(ukr)

For citing:

1. Балаклицька, І.О. Порушення сну, його механізми та корекція у хворих на гастроезофагеальну рефлюксну хворобу та нейроциркуляторну дистонію // Східноєвропейський журнал внутрішньої та сімейної медицини. – 2020. – № 1. – С. 99-105. doi: 10.15407/internalmed2020.01.099

2. Balaklytska IO. Sleep disorders, its mechanisms, and correction in patients with gastroesophageal reflux disease and neurocirculatory dystonia]. Shidnoevr. z. vnutr. simejnoi med. 2020;1:99-105. doi: 10.15407/internalmed2020.01.099. Ukrainian.

References:

1. Axelsson J, Ingre M, Kecklund G, Lekander M, Wright K, Sundelin T. Sleepiness as motivation: a potential mechanism for how sleep deprivation affects behavior. Sleep, zsz291; 2019. http://dx.doi.org/10.1093/sleep/zsz291
https://doi.org/10.1093/sleep/zsz291

2. Berger M, Gray J, Roth B. The Expanded Biology of Serotonin. Annual Review of Medicine. 2009;60(1):355-366. http://dx.doi.org/10.1146/annurev.med.60.042307.110802
https://doi.org/10.1146/annurev.med.60.042307.110802

3. Borbély A, Daan S, Wirz-Justice A, Deboer T. The two-process model of sleep regulation: a reappraisal. Journal of Sleep Research. 2016;25(2):131-143. http://dx.doi.org/10.1111/jsr.12371
https://doi.org/10.1111/jsr.12371

4. Bordbar G, Bolandnazar, NS. Gastroesophageal reflux disease (GERD): prevalence and association with Psychological Disorders among medical sciences students. International Journal of PharmTech Research. 2015;8(7):120-130.

5. Cappuccio F, Taggart F, Kandala N, Currie A, Peile E, Stranges S, Miller M. Meta-Analysis of Short Sleep Duration and Obesity in Children and Adults. Sleep. 2008;31(5):619-626. http://dx.doi.org/10.1093/sleep/31.5.619
https://doi.org/10.1093/sleep/31.5.619

6. Chen J, Wen S, Hsu C, Yi C, Liu T, Chen C, Wang C. Clinical characteristics and psychosocial impact of different reflux time in gastroesophageal reflux disease patients. Journal of the Formosan Medical Association. 2017;116(2):123-128. http://dx.doi.org/10.1016/j.jfma.2016.01.016
https://doi.org/10.1016/j.jfma.2016.01.016

7. Ferracioli-Oda E, Qawasmi A, Bloch M. Meta-Analysis: Melatonin for the Treatment of Primary Sleep Disorders. PLoS ONE. 2013;8(5):e63773. http://dx.doi.org/10.1371/journal.pone.0063773
https://doi.org/10.1371/journal.pone.0063773

8. Iwakura N, Fujiwara Y, Shiba M, Ochi M, Fukuda T, Tanigawa T, Yamagami H, Tominaga K, Watanabe T, Arakawa T. Characteristics of Sleep Disturbances in Patients with Gastroesophageal Reflux Disease. Internal Medicine. 2016;55(12):1511-1517. http://dx.doi.org/10.2169/internalmedicine.55.5454
https://doi.org/10.2169/internalmedicine.55.5454

9. Jha L, Fass R, Gadam R, Maradey-Romero C, Nasrollah L, Hershcovici T, Quan S, Dickman R. The Effect of Ramelteon on Heartburn Symptoms of Patients With Gastroesophageal Reflux Disease and Chronic Insomnia. Journal of Clinical Gastroenterology. 2016;50(2):e19-e24. http://dx.doi.org/10.1097/mcg.0000000000000322
https://doi.org/10.1097/MCG.0000000000000322

10. Lim K, Morgenthaler T, Katzka D. Sleep and Nocturnal Gastroesophageal Reflux. Chest. 2018;154(4):963-971. http://dx.doi.org/10.1016/j.chest.2018.05.030
https://doi.org/10.1016/j.chest.2018.05.030

11. Oparin A, Kornienko D. Formation process of motor-evacuatory disorders in patients with gastroesophageal reflux disease and concomitant obesity. Gastroenterologie a hepatologie. 2017;71(2):145-149. http://dx.doi.org/10.14735/amgh2017csgh.info01
https://doi.org/10.14735/amgh2017csgh.info01

12. Oparin A, Kudriavtsev A, Oparin A. Implementation mechanisms of psychosomatic disorders in gastroesophageal reflux disease with concomitant chronic obstructive pulmonary disease. Medica Jadertina. 2016;46(3-4):125-132. http://dx.doi.org/10.21303/2504-5679.2020.001080
https://doi.org/10.21303/2504-5679.2020.001080

13. Paul K. Serotonin and sleep: breaking the cycle (Commentary on Nakamaru-Ogiso et al.). European Journal of Neuroscience. 2012;35(11):1761-1761. http://dx.doi.org/10.1111/j.1460-9568.2012.08155.x
https://doi.org/10.1111/j.1460-9568.2012.08155.x

14. Porkka-Heiskanen T. Sleep homeostasis. Current Opinion in Neurobiology. 2013;23(5):799-805. http://dx.doi.org/10.1016/j.conb.2013.02.010
https://doi.org/10.1016/j.conb.2013.02.010

15. Thor PJ, Krolczyk G, Gil K, Zurowski D, Nowak L. Melatonin and serotonin effects on gastrointestinal motility. Journal of Physiology and Pharmacology. 2007;58(6):97-105.

16. Xie Z, Chen F, Li WA, Geng X, Li C, Meng X, Feng Y, Liu W, Yu F. A review of sleep disorders and melatonin. Neurological Research. 2017;39(6):559-565. https://doi.org/10.1080/01616412.2017.1315864.
https://doi.org/10.1080/01616412.2017.1315864