Assessment of the relationship between gastroesophageal reflux disease and sleep quality in physicians

Objective: Gastroesophageal reflux disease (GERD) is one of the most common disorders of the gastrointestinal system, negatively affecting patients' quality of life and potentially leading to esophagitis and other complications. Resident physicians, who are frequently exposed to excessive workload, long and frequent shifts, extended training periods, poor dietary habits, psychological stress, anxiety, and sleep disturbances, are considered to be at increased risk for GERD. This study aimed to evaluate the prevalence of GERD among physicians and to assess the relationship between GERD and sleep quality. Materials and Methods: This study was approved by the Ethics Committee of Selçuk University Faculty of Medicine (Decision No: 2024/366, dated 16.07.2024). The study was conducted at Selçuk University Faculty of Medicine Hospital. The study population consisted of resident physicians working at Selçuk University Faculty of Medicine Hospital during the 2024–2025 academic year. A total of 446 participants, representing 80% of the 557 resident physicians, were included in the study. Data were collected face-to-face using a four-part questionnaire. The first part included a 21-item Sociodemographic Information Form; the second part utilized the Reflux Disease Questionnaire (RDQ) for GERD diagnosis; the third part employed the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality; and the fourth part included body composition measurements. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25.0, with a p-value <0.05 considered statistically significant. Results: The mean age of the participating physicians was found to be 28.82 ± 3.59 years. Of the physicians, 43.9% were male (n=196) and 56.1% were female (n=250). The prevalence of GERD in the study was determined to be 42.6%. Among physicians with GERD, the rate of being married was statistically significantly higher compared to those without GERD. Additionally, living with a spouse was found to be significantly more common among physicians with GERD than those without. The proportion of physicians engaging in physical activity 3–4 times per week was significantly lower in the GERD group compared to those without GERD (p<0.001). The frequency of consuming spicy, oily, and tomato paste–based foods was statistically significantly higher among physicians with GERD (p<0.001). Similarly, eating within two hours before sleep was significantly more common in the GERD group than in those without GERD (p=0.011). The frequency of tea or coffee consumption of three or more cups per day was also significantly higher in the GERD group (p<0.001). The prevalence of obesity and the level of visceral fat were both found to be significantly higher among physicians with GERD (p<0.001 for both). Poor sleep quality was significantly more frequent among physicians with GERD. No statistically significant associations were found between GERD and gender, smoking and alcohol consumption, presence of chronic disease, medication use, medical specialty, or work schedule. In the evaluation of sleep quality among physicians, 55.8% (n=446) were found to have poor sleep quality, while 44.2% had good sleep quality. Among those with poor sleep quality, the frequency of eating within two hours before sleep was significantly higher (p=0.002). The use of night lights was also significantly more common among those with poor sleep quality (p=0.010). Physicians with poor sleep quality had significantly higher rates of obesity (p<0.001) and visceral fat accumulation (p<0.001). Working in a surgical specialty and taking night shifts were significantly more common among physicians with poor sleep quality. No significant associations were observed between sleep quality and gender, marital status, cohabitation, physical activity, tea or coffee consumption, use of blackout curtains, or use of mobile phones before sleep. The prevalence of GERD was significantly higher among physicians with poor sleep quality (p<0.001). Conclusion: Occupational stressors such as long shift hours, rotating work schedules, and heavy workload play a significant role in the development of GERD among physicians. Therefore, regular screening programs should be implemented for the early diagnosis of GERD, and individuals exhibiting GERD-specific symptoms should be promptly referred to gastroenterology units. Factors such as shift duration, number of rotations, and frequency of night work should be re-evaluated, and work schedules should be adjusted to support physicians' access to adequate and high-quality sleep. When developing health policies targeting physicians, not only physical health but also gastrointestinal and neuropsychiatric indicators should be taken into account. A holistic approach should be adopted by considering the bidirectional relationship between GERD and sleep health. Keywords: Gastroesophageal Reflux Disease, Physicians, Sleep Quality