Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 26 May 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Acid suppression improves sleep in minimally symptomatic GERD patients

This month's Digestive Diseases and Sciences examines GERD as an etiology of sleep disturbance in subjects with insomnia and minimal reflux symptoms.

News image

fiogf49gjkf04

Gastroesophageal reflux disease (GERD) is a well-recognized cause of impaired sleep in patients with frequent GERD symptoms, as well as those with sleep apnea.

GERD's role in sleep disturbance of minimally symptomatic patients with poor sleep quality is less clear.

After 2 weeks of treatment, 19% had normalization of sleep efficiency
Journal Digestive Diseases and Sciences

Dr Nicholas Shaheen and colleagues from North Carolina, USA explored the prevalence of GERD-related sleep disturbance in minimally-symptomatic subjects with demonstrated insomnia.

The research team assessed the changes in sleep efficiency in these subjects after vigorous acid suppression.

The team recruited subjects aged 18 to 75 years reporting at least 6 months of insomnia, and sleep difficulty at least 3 nights per week.

Subjects with a body mass index over 30, a history of snoring or ongoing use of proton pump inhibitor or H2 receptor antagonist were excluded.

The team reported that subjects underwent concurrent a sleep study with a dual channel 24-hour pH study.

Sleep efficiency was defined as the percentage of time after sleep initiation that the subject actually slept.

Spontaneous arousal index, defined as the number of arousals per hour, were calculated.

Patients demonstrating poor sleep quality had a sleep efficiency of less than 83%, and more than 10 arousals per hour for those aged under 45 years, and more than 15 for those who were 45 or older.

Patients with poor sleep quality and no obstructive sleep apnea were treated with oral rabeprazole 20 mg BID for 14 days.

The researchers reported that after 14 days, the subjects underwent repeat sleep study with pH monitoring.

The GERD Symptom Assessment Scale, the Epworth Sleepiness Scale, and the Functional Outcomes of Sleep Questionnaire were administered to subjects at study inception and after 2 weeks of therapy.

The researchers enrolled 24 subjects reporting insomnia, and 20 met criteria for disordered sleep and no obstructive sleep apnea.

The team noted that 17 patients completed both the first and second studies, and 16 were adequate for analysis.

Baseline Symptom Assessment Scale demonstrated trivial or no reflux symptoms in the cohort.

No subject scored more than 8 out of 45 on Symptom Assessment Scale, corresponding to a median rating of reflux symptoms of ‘not at all'.

The research team observed that 25% of patients demonstrated abnormal pH studies at baseline.

All of these patients had normalization of acid exposures on proton pump inhibitor.

The team noted that after 2 weeks of treatment, 19% had normalization of sleep efficiency.

However, 33% of patients with normal Johnson-DeMeester scores had normalization of sleep efficiency after 2 weeks of treatment.

Repeated measures analysis showed significant improvement in spontaneous arousal index between the first and second study for the whole group.

Pre- and post-therapy Epworth Sleepiness Scale, and Functional Outcomes of Sleep Questionnaire scores were not significantly different.

Dr Shaheen's team concluded, "Despite the lack of GERD symptoms, a significant minority of subjects with sleep disturbance have abnormal acid exposures."

"These preliminary data suggest that aggressive treatment of GERD in such patients may result in improvement in sleep efficiency."

Dig Dis Sci 2008: 53(6): 1493-9
12 May 2008

Go to top of page Email this page Email this page to a colleague

 25 May 2018 
Colorectal cancer–specific mortality
 25 May 2018 
Technology to increase colorectal cancer screening
 25 May 2018 
Post‐operative complications in elderly IBD
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 24 May 2018 
Precision medicine for tumors
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 23 May 2018 
High body mass index is and ulcerative colitis
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
Depressive symptoms in IBD youth
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Fecal incontinence and quality of life in IBD
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
Hep B in the Grey Zone
 15 May 2018 
New therapies for CDI
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 09 May 2018 
Esophageal dilatation in clinical practice 
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us