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"Functional somatic syndromes" is one of the new terminologies in the medicine. However most of the primary-care physicians have already noticed the existence of the patient appeal their physical symptoms which is medically unexplained for a long time. On the other hand, the psychiatrists looked same physical symptoms as a symbolic representation of the patients' psychological conflicts, somatoform disorders. This new terminology "functional somatic syndromes" intends to integrate those two dimensions and to understand the patient as a whole person. In this special issue, we show the multi-dimensional aspects of "functional somatic syndromes" and intend to serve the clue to understand the patients with symptoms to all primary-care physicians in Japan.

The prevalence of gastroesophageal reflux disease (GERD) is increasing in Japan. Symptoms of GERD negatively affect their quality of life and sleep. There are several reasons for sleep disorder with GERD as follows. Nocturnal GERD symptoms sometimes directly avoid sleeping. Sleep apnea syndrome and GERD are sometimes concomitant. The both are sharing similar risk factor such as obesity and cause sleep disorder. When untypical symptoms of GERD are not diagnosed, patients are severely anxious about their physical condition. Then they feel stressful and sometimes get secondary depressive state including sleep disorder. We had better take care about patients' psychosocial factors and treat symptoms of GERD and sleep disorder together with holistic approach.