Gastrointestinal Symptoms are More Common in Young School Aged Children with Sleep Disturbances

Abstract

Purpose: Sleep has significant influence on the physiology of the upper gastrointestinal tract. As a result there is substantial literature exploring the association between gastrointestinal symptoms, particularly gastroesophagel reflux and sleep in adults. However, studies exploring relationship between sleep and gastrointestinal symptoms/disorders in children are lacking. In this study we examine gastrointestinal system related symptoms in young school aged children with versus without sleep disturbances. Methods: A random sample of local elementary school children (K-5) was assessed using a two-phased strategy. During Phase I, over the course of 5 years, a 16 item screening questionnaire based on validated survey was sent home to parents of every student in these school districts (N = 7, 312) with a 78.5% response rate. Among this sample, randomly selected children and their parents were selected to participate in the Phase II of the study which consisted of detailed medical history, physical examination, and 9-hour overnight polysomnogram. The final sample of 687 was divided into two groups based on parents response to sleep related items (Trouble falling asleep? and Restless during sleep?) in the screening questionnaire. 267 (38.9%) of these children had “often” or “very often” had either or both of these sleep disturbances [SD (sleep disturbances) group] and 420 (61.1%) either sometimes or never had these sleep disturbances (NON-SD group). Results: The two groups did not differ in gender or percentile for body mass index for age. The SD group was older (SD 8.99 + 1.7; NON-SD 8.5 +1.6). SD group had significantly more stage 2 NREM and REM sleep but significantly less stage 3 NREM sleep. The two groups did not differ in apnea/hypopnea index. Significantly more children in the SD group reported heartburn (SD: 7.5%; NON-SD: 3.6%; X2 = 5.1, df = 1, P= .024), pain/colic (SD 12.4%; NON-SD 6.7%; X2 = 6.4, df = 1, P= .012), vomiting (SD 4.1%; NON-SD 1.4%; X2 = 4.8, df = 1, P= .028), and other (SD 10.2%; NON-SD 5.7%; X2 = 4.6, df = 1, P= .031) gastrointestinal symptoms in comparison to NON-SD group. However, there was no difference in complaints of regurgitation. Conclusion: In this population based sample of young children gastrointestinal system related symptoms were more common in children who also had sleep disturbances. Further, there seems to be some polysomnographic changes in the children with parent reported sleep disturbances.Table: of Results