Gastroesophageal Reflux and the Lung by Keith C. Meyer & Ganesh Raghu

Author:Keith C. Meyer & Ganesh Raghu
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

Prevalence of Sleep-Related GER

Population-based studies show that sleep-related GER is quite prevalent, especially in GER patients. The American Gastroenterological Association sponsored a national, population-based telephone survey of 1,000 people with heartburn at least three times weekly (conducted by the Gallup Organization) that noted that 79% of people had sleep time heartburn [23]. Of those with sleep time heartburn, 75% reported that heartburn disrupted their sleep, 63% believed that this heartburn negatively affected their ability to sleep, and 40% believed that it impaired their wake time functioning [23]. Of those subjects taking prescribed GER medications, only 49% of subjects had adequate control of sleep-related GER symptoms, and in those subjects taking over-the-counter GER medications, only 29% had control of sleep-related GER symptoms [23]. It should be noted, however, that this study was performed before PPIs were available for use over the counter.

Gerson et al. [24] reviewed all literature published between 1984 and 2007 and identified 59 studies that evaluated sleep-related GER. In five population studies, the mean prevalence of sleep-related heartburn was 54  ±  22%. A high prevalence rate was also noted in a French population survey of 562 general practitioners evaluating 36,663 patients [25]. They noted a GER prevalence of 8%, and of these, 65% reported sleep-related GER symptoms or 5% of the entire patient population [25].

In a study utilizing existing cardiovascular cohorts evaluating outcomes of sleep-disordered breathing, the Sleep Heart Health Study, Fass et al. [18] examined sleep-related heartburn prevalence in 15,315 participants. Twenty-five percent reported sleep-related heartburn more than once weekly [18]. Using multivariate logistic regression models, they found predictors of sleep-related heartburn, including the presence of snoring and daytime sleepiness, insomnia, and the use of benzodiazepines as outlined in Table 8.1.Table 8.1Predictors of heartburn during sleep

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