and Gastroesophageal Reflux Disease (GERD)
Sleep is an important
element in patientís
quality of life. Sleep related gastroesophageal reflux (GER) is important
in the pathogenesis of Esophagitis. During sleep, acid contact time with
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.