Reflux-associated features of dyssomnias and disorders in the emotional and personality sphere in patients with small hiatal hernias


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Abstract

Background. The course of small hiatal hernia (SHH) is accompanied by persistent reflux syndrome and the need for long-term administration of drugs, which certainly has a negative effect on the psychoemotional sphere of patients and the sleep-wakefulness pattern. However, this issue has not been studied in detail for patients of this category. Objective. Evaluation of the features of reflux-associated dyssomnias and disorders in the emotional and personality sphere in patients with small hiatal hernias. Methods. Cross-sectional observational (analytic) study with participation of patients with SHH (I-II degrees) and reflux esophagitis (RE) was performed. Endoscopic and X-ray contrast studies of the stomach were performed to diagnose HH and the severity of RE. The emotional and personality sphere and sleep disorders in patients were assessed using the Mini-Mult, TATD questionnaires and the Yu.A. Alexandrovsky sleep disorder scale. Results. With the predominance of gastroesophageal reflux (GER), the dominance of hypochondriacal and depressive tendencies in the emotional sphere was revealed; in cases of duodenogastroesophageal reflux, signs of psychopathy and psychasthenia were dominated. In GER, harmonious and ergopathic types of attitude towards the disease prevailed, and in duodenogastroesophageal reflux (DER) - anxious, hypochondriac and neurasthenic types. Dyssomnia with predominant GER was observed in 76.2% of cases, with DGER - in 30.6%. Presomnic and intrasomnic disorders prevailed, which were more common in GER. The calculated indices of the severity of dyssomnia showed statistically significant differences for all types of sleep disorders, depending on the type of reflux into the esophagus, while the severity of ER did not show such differences. Conclusion. Depressive and hypochondriacal tendencies, anxious, hypochondriac and neurasthenic responses to the disease prevailed in the emotional-personality sphere in patients with SHH, regardless of the type of reflux and the severity of RE. Sleep disorders, regardless of the severity of ER, were characterized by mild to moderate presomnic and intrasomnic disorders, most pronounced when GER dominated.

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About the authors

G. S Dzhulay

Tver State Medical University

Email: djoulai@mail.ru
Tver, Russia

I. A Zyabreva

Tver State Medical University

Tver, Russia

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