Effect of Subjective and Objective Sleep Quality on Subsequent Peptic Ulcer Recurrence in Older Adults

Boye Fang, Huiying Liu, Shuyan YANG, Ruirui Xu, Gengzhen Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

6 Citations (Scopus)


OBJECTIVE: To examine the effect of subjective and objective sleep quality on subsequent recurrence of peptic ulcer disease (PUD) among older patients after Helicobacter pylori eradication. SETTING: Eight grade A hospitals in China. PARTICIPANTS: Of 1689 older Chinese with H. pylori–infected PUD recruited between January 2011 and October 2014, H. pylori were eradicated and PUD was cleared in 1538 patients by the end of 2014; 1420 of these patients were followed up for up to 36 months. MEASUREMENTS: Using multiple measures at 6-month intervals, PUD recurrence was determined with esophagogastroduodenoscopy. Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index. Objective sleep quality domains were measured using an accelerometer, including sleep onset latency, sleep efficiency, total sleep time, and number of awakenings. RESULTS: This study documented a 36-month cumulative PUD recurrence of 8.3% (annual rate = 2.8%). Multivariate analyses showed that participants who reported poorer sleep quality were more likely to experience PUD recurrence during the 36-month follow-up period (hazard ratio [HR] = 1.895; 95% confidence interval [CI] = 1.008-3.327). Regarding objective sleep quality domains, longer sleep onset latency (HR = 1.558; 95% CI = 1.156-2.278) and more nighttime awakenings (HR = 1.697; 95% CI = 1.168-2.665) increased the risk of PUD recurrence. However, a longer total sleeping time protected against PUD recurrence (HR = 0.768; 95% CI = 0.699-0.885). CONCLUSIONS: Poor sleep quality predicts a greater risk of PUD recurrence. Accurate diagnosis and effective treatments should, therefore, be provided for older adults afflicted with poor sleep, particularly for those who previously had PUD. It is equally important to include sleep assessment as an integral part while dealing with these patients.

Original languageEnglish
Pages (from-to)1454-1460
Number of pages7
JournalJournal of the American Geriatrics Society
Issue number7
Early online date11 Apr 2019
Publication statusPublished - Jul 2019

Scopus Subject Areas

  • Geriatrics and Gerontology

User-Defined Keywords

  • older patients
  • peptic ulcer disease recurrence
  • poor sleep quality


Dive into the research topics of 'Effect of Subjective and Objective Sleep Quality on Subsequent Peptic Ulcer Recurrence in Older Adults'. Together they form a unique fingerprint.

Cite this