Longitudinal effect of Sleep Quality on Subsequent Peptic Ulcer Recurrence in Older Patients after Helicobacter Pylori Eradication: Roles of Pharmacological and Nonpharmacological Treatments

Abstract

Abstract Purpose This study examined whether poor sleep quality at baseline predict the subsequent recurrence of peptic ulcer disease (PUD) in older patients after H. pylori eradication, and to investigate whether nonpharmacological treatment and sleeping pills play a role in this association. Method s Of 1,126 older Chinese patients with H. pylori-infected PUD from Eight Grade-A hospitals in the People’s Republic of China (PRC) recruited between 2010 and 2015, 1,028 obtained H. pylori eradication and healed PUD by the end of 2015, and 950 were followed for up to 36 months. PUD recurrence was confirmed with esophagogastroduodenoscopy. Sleep quality at baseline was measured by the Pittsburgh sleep quality index (PSQI). Information of use of pharmacological and non-pharmacological treatments was extracted from their medical and social service records. Results The results revealed that baseline poor sleep quality was associated with PUD recurrence during the 36-month follow-up period (HR 1.894 (1.007, 3.561)). However, older patients with poor sleep quality who consumed sleeping pills were more likely to experience PUD recurrence, compared to those with moderate-to-good sleep quality (HR 1.588 (1.126, 2.589)). No significant difference was noted between older patients with moderate-to- good sleep quality and those with poor sleep quality who used nonpharmacological sleep treatment alone (HR 1.395 (0.729, 2.669)) or who simultaneously used pharmacological and nonpharmacological sleep treatments (HR 1.162 (0.901, 2.286)). Conclusions Poor sleep quality is associated with a greater risk of PUD recurrence. However, using nonpharmacological sleep treatment may alter this trajectory.