The relationship between complaints of night-time heartburn and sleep-related gastroesophageal reflux

Abstract

This study investigated whether the complaint of night-time heartburn (NHB) as opposed to daytime heartburn (DHB) is a reliable reflection of actual sleep-related reflux events. Three groups of individuals were studied: individuals with complaints of NHB at least twice per week (n = 24), individuals with complaints of DHB (n = 23), and normal participants without any complaints of regular heartburn during the day or night (n = 25). All three groups were studied on one occasion with combined pH monitoring and polysomnography, and subjective questionnaires about sleep disturbance and sleep quality were given to all participants. The NHB group had significantly more sleep-related reflux events compared with both DHB and control groups (P < 0.01). DHB subjects had significantly (P < 0.05) more sleep-related reflux events than normal controls. Total acid contact time (ACT) was significantly (P < 0.05) elevated in the NHB group compared with both the DHB and control group. Sleep-related ACT was also significantly (P < 0.05) elevated in the NHB group compared with the other two groups, while upright (daytime) ACT was not significantly different. The NHB group was significantly (P < 0.05) worse regarding measures of both objective and subjective sleep quality. Subjects with exclusively DHB do have sleep-related reflux that is greater than normal controls. Subjects with NHB have significantly more sleep-related reflux, and both objective and subjective sleep abnormalities compared with normal controls. Complaints of NHB reflect sleep-related reflux events and may be indicative of a more clinically significant condition.

Gastroesophageal reflux disease: recent advances and its association with sleep

“…The results showed that the nighttime heartburn group had significantly more sleep‐related reflux events (total acid contact time and average duration of reflux events) compared with both the daytime heartburn group and the control group. Therefore, the nighttime heartburn group had significantly worse parameters with regard to objective and subjective sleep quality . Risk factors for GERD‐related sleep disturbances include smoking, alcohol use, and higher grades of esophagitis; these are among the more severe typical reflux symptoms during the daytime .…”

“…Therefore, the nighttime heartburn group had significantly worse parameters with regard to objective and subjective sleep quality. 51 Risk factors for GERD-related sleep disturbances include smoking, alcohol use, and higher grades of esophagitis; these are among the more severe typical reflux symptoms during the daytime. 50 A previous study compared the prevalence of nGER symptoms in OSA patients and in the general population and indicated that the prevalence of frequent nGER symptoms was increased in the OSA patients (10.2% vs. 5.5%; P < 0.001).…”