Sleep and Gastroesophageal Reflux Disease (GERD)

Sleep is an important element in patient’s quality of life. Sleep related gastroesophageal reflux (GER) is important in the pathogenesis of Esophagitis. During sleep acid contact time with esophageal mucosa is increased and acid clearance is reduced due to a number of physiological reasons. Acid contact and heartburn produces arousal from sleep. The arousal produces disruption and fragmentation of sleep, which may manifest as day time fatigue and sleepiness.

Occurrence of heartburn at least twice a week is an independent risk factor for sleep complaints and disturbances.

It has been found that nighttime gastroesophageal reflux can cause major sleep disturbance. Acid reflux mostly occurs during non-rapid eye movement and is associated with prolonged acid clearance. Appropriate treatment of GERD with PPIs improves work performance and productivity and quality of life in patients suffering from nighttime heartburn by improving the time and quality of sleep. In addition, sleep apnea and pulmonary manifestations of GERD are more common in patients suffering from nighttime GER. Night time GER may be reduced by elevating head of bed at least 6 inches or using wedge shaped pillows specifically designed to prevent reflux, avoiding eating or drinking at least 2 hours before retiring at night, avoiding large meals at night and finally using acid reducing medications.