22. Guda N, Partington S, Shaw MJ, Leo G, Vakil N. Unrecognized GERD symptoms are associated with excessive daytime sleepiness in patients undergoing sleep studies. Comparisons of the distribution of oesophageal acid exposure throughout the sleep period among the different gastro-oesophageal reflux disease groups. Predominant nocturnal acid reflux in patients with Los Angeles grade C and D reflux esophagitis.
Also, sleeping people tend to swallow less frequently. This slows the regular esophageal contractions that normally keep food moving down the esophagus and prevent acid from moving back up. Sleepers also produce less saliva, which plays a role in returning esophageal pH levels to normal after an incident of acid reflux. For people who have been diagnosed with GERD, the rate is even higher; three people out of four report having nocturnal GERD symptoms. These individuals are more likely to suffer sleep problems such as insomnia, sleep apnea, and daytime sleepiness as a result of their nighttime heartburn.
When should someone see a doctor?
For them, the only indication they have acid reflux may be a problem with swallowing, a dry nagging cough, the development of asthma, or the repeated loss of oneâ€™s voice (laryngitis). GERD is considered a chronic form of acid reflux.
2. Prepare for nighttime disruptions.
The American Journal of Gastroenterology. Vol. 94, No. 8, 1999. Gravity and anatomy play a huge role in finding relief from nocturnal GERD symptoms.
Gerson LB, Fass R. A systematic review of the definitions, prevalence, and response to treatment of nocturnal gastroesophageal reflux disease. Salivary secretion ceases during sleep, and sleep facilitates proximal acid migration into the esophagus. shows the association between sleep disturbance and reflux esophagitis. Bottom shows that increased ORs for GERD among individuals with sleep disturbance. Sleep disturbances are common; so are GI symptoms.
There was a continuation of nighttime reflux, and the majority of nighttime reflux events under those conditions were nonacid. We also found, however, that patients woke up as frequently or had arousal responses from sleep as frequently with nonacid reflux as with acid reflux, and there was no difference with the proximal migration of acid events versus nonacid events. This suggests to me that the esophagus is capable of recognizing nonacid reflux during sleep and providing the same protective measures that would be in place with nonacid events as with acid events. making the return of acid to your stomach more difficult. And, depending on how you are sleeping, your esophagus can actually be below your stomach allowing acid to freely flow out and then just sit in your esophagus, lungs, throat, and sinuses.
People with GERD often have a hard time getting a good night’s sleep because of persistent acid reflux. Find out how to cut down on this problem. Tilting the head of your bed upward will raise your head, which can help reduce the chance that your stomach acid will reflux into your throat during the night.
In this article, learn more about GERD. Getting eight hours of sleep is sometimes more difficult to achieve than top ranking in an Ivy League school. Those eight hours are elusive for many of us for a variety of reasons, such as children, work, school and a myriad of other responsibilities, causing not only sleeplessness but also stress.
Gastroesophageal reflux disease (GERD) is a chronic disorder and the most common disease that affects the esophagus. Several studies have estimated that 1 in 5 (20%) of the U.S. adult population experience GERD-related symptoms at least once a week. Studies have also demonstrated that up to 4 in 5 (79%) of GERD patients experience nighttime symptoms.
Most often this will occur following a meal. Researchers found that acid refluxing at night resulted in sleep arousal 89 percent of the time in participants (with and without GERD) given placebo but only 40 percent in those given zolpidem. In controls given placebo, acid reflux events lasted approximately one to two seconds; in controls given zolpidem, they lasted roughly three to 30 seconds. In GERD patients given placebo, the acid reflux events lasted about 20 to 55 seconds as compared to about four to eight minutes with zolpidem. With zolpidem, reflux events lasted approximately seven to 15 minutes when no arousal occurred and 30 to 68 seconds when an arousal was recorded.
An advancement that helped us to better understand the impact of GERD on sleep was the incorporation of actigraphy (a watch-like device that can determine if patients are asleep or awake) with their pH test measuring acid exposure matched by time. This combined technique allows us to determine the relationship between gastroesophageal reflux events, symptoms, and sleep and awake periods. It does appear that GERD and sleep have a bi-directional relationship.
Many people donâ€™t realize that how you sleep directly affects how you reflux at the night as anatomy and gravity play a big role in heartburn symptom frequency, length and severity. WO In a patient with a suspected nighttime heartburn component, a clinician may choose to follow up with the patient more frequently to ensure that the nighttime symptoms are being relieved because, as previously mentioned, the continued presence of nighttime reflux is a significant factor in an individual who may be refractory to treatment.
The reason is not entirely clear. One hypothesis holds that right-side sleeping relaxes the lower esophageal sphincter, between the stomach and the esophagus.