Effect of Antidepressants on Sleep in Functional Dyspepsia
Bibliographic record
Abstract
Introduction: Individuals with functional dyspepsia (FD) frequently report non-gastrointestinal symptoms. Little is known about sleep quality in those with FD. Aim: To evaluate changes in sleep quality in response to antidepressant therapy in FD patients. Methods: The Functional Dyspepsia Treatment Trial (FDTT) was a 12-week, multi-center, randomized, double blind, placebo-controlled trial evaluating antidepressants in FD. Subjects meeting Rome II criteria were randomized to placebo (PLA), 50 mg amitriptyline (AMI), or 10 mg escitalopram (ESC), were excluded if receiving antidepressant or psychotropic medication, had current drug/alcohol abuse, or scored ≥11 on the Hospital Anxiety Depression Scale (HADS). A Pittsburgh Sleep Quality Index (PSQI) was completed at baseline and after treatment. The association of baseline values with treatment group was assessed using the Kruskal-Wallis test. An ITT ANCOVA (based on ranks) using baseline and balancing factors as covariates was used to assess post-treatment effects. Treatment effects on changes in PSQI scores were also assessed using the Kruskal-Wallis test. Results: 292 subjects were randomized: mean age was 44, 219 (75%) were female. Baseline and posttreatment PSQI data were available from 261 (89%) and 185 (63%) individuals. Baseline mean global scores across the group indicated poor sleep quality (mean scores >5) in all treatment arms. The worst subscore was seen for Sleep Efficiency with an overall mean of 3.0 (SE 0.01) in all three arms. After treatment, Global Sleep and Sleep Efficiency scores remained poor across the three treatment arms. Overall treatment effects on Sleep Duration scores were observed (p=0.019) with lower (better) scores in the AMI arm compared to the PLA and ESC arms, but the change from baseline did not differ significantly among the treatment arms. Post-treatment scores for Sleep Quality, Sleep Latency, Sleep Efficiency, Sleep Disturbance, Sleep Medication, Daytime Dysfunction did not differ among treatment arms. There were overall borderline treatment effects on changes in Sleep Quality (p=0.05) with improved sleep (decreased scores) in the PLA arm compared to the antidepressant arms. Conclusion: Individuals with FD commonly report poor sleep quality. Sleep duration scores were better in those receiving amitriptyline, suggesting that a potential benefit of amitriptyline is improved length of sleep; however, its effects on sleep quality are otherwise modest at best.Table 1
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".