A Study On The Correlation Between Sleep And Gastric Cancer In Wuwei General Population Cohort

OBJECTIVETo master the sleep health data of the population through investigating the sleep status and related influencing factors of Wuwei general population cohort established in high-risk areas of gastric cancer.To analyze the correlation between sleep factors and gastric cancer and precancerous disease,in order to provide epidemiological basis for the intervention to solve the sleep health problems of residents in areas,and to provide important theoretical basis for the establishment of prevention and control system of gastric cancer in Wuwei City.METHODSBy means of stratified cluster sampling,general population aged 35-70 from 9 pilot towns in Wuwei City,Gansu Province was selected to establish a research cohort,descriptive analysis was conducted on the distribution characteristics of the cohort in demography,lifestyle,and previous disease history,family history of upper gastrointestinal cancer and digestive system syndromes.A cross-sectional study was conducted to analyze the risk factors associated with total sleep time(TST)per night,insomnia,excessive daytime sleepiness(EDS)and restless legs syndrome(RLS)by univariate analysis and multivariate logistic regression analysis.The patients with gastric cancer,precancerous lesions and non-atrophic gastritis confirmed by gastroscopy and pathology in the cohort were selected as the research objects;Logistic regression model was established to analyze sleep factors related to gastric cancer,precancerous lesions and non-atrophic gastritis.RESULTS1.The mean TST per night of the Wuwei general population cohort was 8.8 ± 1.0h.In the cohort,58.7% of the subjects were shown sleeping ≥ 9h per night,7.9% were shown sleeping ≤ 7h per night.Education,family size,neck circumference,waist circumference,fried food,fast food,family history of upper gastrointestinal cancer,gastroesophageal reflux syndrome and irritable bowel syndrome were independent risk factors for TST ≤ 7h;Age,family income,waist circumference,drinking,exercise,time of eating fruits and vegetables,hot food,fast food,previous history of peptic ulcer,dyspepsia syndrome and gastroesophageal reflux syndrome were independent risk factors for TST ≥ 9h.2.The prevalence of insomnia in Wuwei general population cohort was 13.9%,mild insomnia was 9.8%,and moderate to severe insomnia was 4.1%.Age,waist circumference,past smoking,hot food,previous history of hypertension,gallbladder disease and peptic ulcer,family history of upper gastrointestinal tumors,dyspepsia syndrome,and peptic ulcer syndrome,syndrome of gastroesophageal reflux and irritable bowel syndrome were independent risk factors for mild insomnia;Age,fast food,previous history of gallbladder disease and peptic ulcer,dyspepsia syndrome,peptic ulcer syndrome,gastroesophageal reflux syndrome and irritable bowel syndrome were independent risk factors for moderate to severe insomnia.3.The prevalence of EDS in the Wuwei general population cohort was 2.2%.Education,overweight and obesity,neck circumference,past smoking,time of eating fruits and vegetables,fried foods,previous history of peptic ulcer,peptic ulcer syndrome and irritable bowel syndrome were independent risk factors for EDS.4.The prevalence of RLS in the Wuwei general population cohort was 1.9%.Age,fruits and vegetables,hot food,previous history of hypertension,gallbladder disease and peptic ulcer,family history of upper gastrointestinal cancer,dyspepsia syndrome,gastroesophageal reflux syndrome,peptic ulcer syndrome and irritable bowel syndrome were independent risk factors for RLS.5.The prevalence of insomnia in patients with gastric cancer was 17%,the prevalence of EDS was 2.1%,and RLS was 3.4%.The prevalence of insomnia in patients with low grade intraepithelial neoplasia(LGIN)was 15.1%,the prevalence of EDS was 2.1%,and RLS was 3.4%.The prevalence of insomnia in patients with intestinal metaplasia(IM)was 14.7%,the prevalence of EDS was 0.8%,and RLS was 2.3%.The prevalence of insomnia in patients with atrophic gastritis(AG)was 14.2%,the prevalence of EDS was 2.2%,and RLS was 1.6%.Insomnia,EDS and RLS were not correlated with gastric cancer(P > 0.05).EDS was an independent risk factor for LGIN,IM and AG(P < 0.05).Sleeping ≥ 9h per night was an independent risk factor for gastric cancer,LGIN and IM(P < 0.05).Napping for >30 min was an independent risk factor for gastric cancer,AG and non-atrophic gastritis(NAG)(P < 0.05).CONCLUSION1.There was a higher proportion of sleep too much(TST ≥ 9h)in the Wuwei general population cohort,while the proportion of sleep too little(TST ≤ 7h)was lower.Fried food,fast food,family history of upper gastrointestinal cancer and irritable bowel syndrome may be the main risk factors for TST ≤ 7h.Time of eating fruits and vegetables,fast food,exercise,and family history of upper gastrointestinal cancer may be the main independent risk factors for TST ≥ 9h.2.The prevalence of insomnia in Wuwei general population cohort is relatively low;Dyspepsia syndrome,peptic ulcer syndrome,gastroesophageal reflux syndrome and irritable bowel syndrome may be the main independent risk factors for insomnia.The prevalence of EDS was significantly lower than the national average;Fried foods,time of eating fruits and vegetables,peptic ulcer syndrome and irritable bowel syndrome may be the main independent risk factors of EDS.The prevalence of RLS is similar to that in other regions of China.Irritable bowel syndrome,previous gallbladder disease,history of peptic ulcer and family history of upper gastrointestinal tumors may be the main risk independent factors for RLS.3.EDS may be an independent risk factor for gastric precancerous lesions;sleeping ≥ 9h per night may be an independent risk factor for gastric cancer,LGIN and IM.Napping >30 minutes may be an independent risk factor for gastric cancer,AG and NAG.