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Gastro-esophageal reflux and associated sleep disruption

Gastro-esophageal reflux is common in patients with sleep disorders, is associated with increased arousal, decreased durations spent in the deeper stages of sleep and poorer sleep-related quality of life, reports the most recent issue of Alimentary Pharmacology and Therapeutics.

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Nocturnal acid reflux is common and could disturb sleep by causing arousals that fragment sleep.

Dr Vakil and colleagues from Milwaukee, Wisconsin undertook a study in order to determine the prevalence of gastro-esophageal reflux symptoms and their association with arousals, stages of sleep and quality of life.

The researchers enrolled patients who were undergoing evaluation for excessive daytime sleepiness and obstructive sleep apnea.

In total, the research team prospectively studied 94 consecutive patients with excessive daytime sleepiness.

The researchers ensured that participants completed the gastrointestinal symptom rating scale, a validated symptom questionnaire for reflux disease, and a disease-specific quality of life questionnaire, the sleep apnea quality of life index.

The research team oversaw an overnight polysomnography for all participants, which the researchers then read in a blinded manner.

Patients with reflux symptoms had significantly more arousals from sleep (43 ± 70/h) than those without
Alimentary Pharmacology and Therapeutics

There were 40 males and 54 females with a mean age of 47 ± 13 years.

The research team recorded reflux symptoms in 67% of patients.

The researchers found that patients with reflux symptoms had significantly more arousals from sleep 43 ± 70/h than those without.

In addition, the team noted that the sleep duration during the second stage of sleep was shorter for those with reflux symptoms than those without.

Patients with reflux spent significantly shorter periods in stage II sleep than those without.

The researchers found that the sleep-related quality of life score in patients with gastro-esophageal reflux was significantly lower than in patients without reflux.

The investigators performed regression analysis which demonstrated a significant inverse correlation between quality of life and reflux symptom score and total spontaneous arousals.

Dr Vakil concluded, "Gastro-esophageal reflux is common in patients with sleep disorders, is associated with increased arousal, decreased durations spent in the deeper stages of sleep and poorer sleep-related quality of life."

Alimentary Pharmacology & Therapeutics; 2004: 20 (10): 1153
10 December 2004

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