Postprandial attenuation of gastric slow waves in anxiety-depression, with and without functional dyspepsia: associations with heart rate variability and sleep quality.

Authors

Lin Du, Jie Yang, Li Jiang, Guiying Zeng, Yanping Shu, Bin Bi

Published in

Frontiers in medicine. Volume 13. Pages 1890716. Epub Jul 27, 2026.

Abstract

Functional dyspepsia (FD) commonly coexists with anxiety, depression, and sleep disturbances. However, it remains unclear whether the burden of psychological symptoms and sleep disturbances is associated with autonomic regulation and meal-induced gastric myoelectrical responses, particularly in individuals without overt FD. This study aimed to explore the relationships among heart rate variability (HRV), sleep quality, and postprandial electrogastrographic changes in adults with symptoms of anxiety-depression (AnxDep), with or without FD.
A single-center cross-sectional observational study enrolled 253 participants across four clinically defined phenotypes: healthy controls (n = 75), FD-only (n = 45), mild-to-moderate anxiety-depression without FD (n = 60), and severe anxiety-depression with FD (n = 73). The design was not a complete factorial design; therefore, group comparisons were interpreted as descriptive phenotype comparisons rather than as estimates of the interaction between anxiety-depression severity and FD status. Anxiety, depression, sleep quality, and FD symptoms were assessed using the self-rating anxiety scale (SAS), self-rating depression scale (SDS), Pittsburgh Sleep Quality Index (PSQI), and a structured FD scale. Surface electrogastrography (EGG) was recorded before and after a standardized meal, and 24-h HRV was monitored. Postprandial response index (PRI) was calculated as the postprandial-to-preprandial normogastria ratio and was analyzed as an exploratory research index. Statistical analyses included group comparisons, correlations, collinearity-aware regression models, and sensitivity analyses; causal mediation analysis was not performed.
HRV indices significantly differed across groups (all p < 0.001). Lower RMSSD and HF values were observed in the FD and anxiety-depression groups, with the lowest vagal-related indices in the severe anxiety-depression with FD group. LF/HF was reported only as a relative spectral ratio and was not interpreted as a direct measure of sympathovagal balance. The anxiety-depression without FD group had preserved absolute normogastria values but a reduced PRI (0.874 ± 0.066 vs. 1.145 ± 0.086 in controls), with all participants in this group showing PRI < 1. In sensitivity analyses, the difference in PRI between the anxiety-depression without FD group and controls persisted after adjustment for BMI or weight, medication exposure, and recruitment source, and after excluding participants using SSRI/SNRIs or sleep medications.
Anxiety-depression symptoms were associated with reduced vagal-related HRV, poorer sleep quality, and a blunted postprandial gastric slow-wave response. In the anxiety-depression without FD group, a PRI < 1 reflected a blunted meal-related slow-wave response despite preserved absolute normogastria values. PRI should be considered an exploratory research endpoint requiring prospective validation.

PMID:
42577285
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

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