Associations of Anxiety, Depression, and Sleep Quality with MNBI, PSPW-I, and ECJ-CI in rGERD, FH, and RH Patients: A Retrospective Study
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Objective
This study examined the impact of anxiety, depression, and sleep quality on mean nocturnal baseline impedance (MNBI), post-reflux swallow-induced peristaltic wave index (PSPW-I), and esophagogastric junction contractile index (EGJ- CI) in patients with refractory gastro-esophageal reflux disease (rGERD), functional heartburn (FH), and reflux hypersensitivity (RH).
Methods
Retrospective analysis included 75 patients aged 18-70 with persistent reflux symptoms despite 8 weeks of proton pump inhibitor (PPI) therapy. Evaluations included esophagogastroduodenoscopy, high-resolution manometry, 24-hour pH- impedance monitoring, and psychological assessments (SAS, SDS, PSQI). Patients were grouped into rGERD, FH, and RH. MNBI, PSPW-I, and EGJ-CI were compared, and correlations with psychological and sleep parameters were analyzed.
Results
Distal MNBI was significantly lower in rGERD (1177.91 ± 707.22 Ω) vs. FH (1995.77 ± 476.02 Ω) and RH (2062.35 ± 509.93 Ω) (P < 0.001). Anxiety prevalence was 85.7% in rGERD, 64.7% in FH, and 67.5% in RH (P = 0.302); depression affected 78.6% of rGERD, 70.8% of FH, and 72.9% of RH patients (P = 0.942). Poor sleep quality was present in >80% of all groups. PSPW-I negatively correlated with anxiety (r = −0.181, P < 0.05) and depression (r = −0.158, P < 0.05), as did proximal MNBI with depression (r = −0.175, P < 0.05). A distal MNBI cutoff of 1531 Ω distinguished rGERD from FH/RH with 71.4% sensitivity and 87.5% specificity (AUC = 0.80).
Conclusion
Anxiety, depression, and poor sleep quality impair PPI efficacy and worsen esophageal acid clearance. Distal MNBI effectively differentiates rGERD from FH/RH. Addressing psychological and sleep disturbances may improve treatment outcomes in refractory reflux patients.
