The effect of sleep quality on peptic-ulcer relapse in older adults

Poor sleep quality and peptic ulcer disease (PUD, a condition when sores known as ulcers develop on the lining of your stomach or in the first part of your small intestine) are both major public health problems that affect the physical and psychological wellbeing of older adults.

Poor sleep quality can be caused by age-related increases in chronic health conditions, medication use, sleep behavior changes, and other issues. It affects around one-third of all older adults. Peptic ulcers are common among older adults, too. They often result from the presence of a specific bacteria, Helicobacter pylori (H. pylori), in our gut. Thanks to the development of treatments for H. pylori infections, however, the rate of recurrent peptic ulcers (ulcers that consistently come back after treatment) has dropped dramatically. Few people who experience a recurrence of ulcers, for example, are infected with H. pylori.

However, that still doesn't explain why some people experience recurrence.

Recently, a team of researchers designed a study to test their hypothesis that other factors besides the bacteria could cause peptic ulcer recurrence—and that poor sleep may be among them. They published their results in the Journal of the American Geriatrics Society.

The researchers enrolled 1,689 patients with H. pylori-infected peptic ulcer disease in their study. The participants received a 10-day course of anti-H. pylori treatment, followed by a four-week anti-ulcer therapy. Four weeks after treatment was completed, patients were tested and examined to see whether their ulcers had healed.

The researchers reported that 1,538 patients had achieved H. pylori eradication and had their peptic ulcers healed. These participants were then enrolled in a sleep study. They wore monitors that provided information about the length and quality of their sleep.

The 1,420 participants who completed the follow-up study were mostly around 69 years old and had a normal body weight. The participants who experienced a recurrence of their peptic ulcer had higher rates of heart disease, diabetes, and excessive alcohol consumption than those who had no recurrence. They also took longer to fall asleep, slept poorly, woke more during the night, and rated their sleep as poor compared to the participants who didn't have a recurrence of ulcers.

The researchers concluded that poor sleep quality does indeed appear to contribute to the recurrence of peptic ulcers. They suggested that their findings highlight the importance of properly treating and preventing sleep problems in older adults with previous H. pylori-infected peptic ulcers.

This summary is from "Effect of subjective and objective sleep quality on peptic ulcer recurrence in older adults.(https://onlinelibrary.wiley.com/doi/10.1111/jgs.15871)" It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Boye Fang, Ph.D.; Huiying Liu, Ph.D. Candidate; Shuyan Yang, Ph.D.; Ruirui Xu, Master; and Gengzhen Chen, MD.