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Sleep and GER

  • Susan M. Harding
Chapter
Part of the Respiratory Medicine book series (RM, volume 2)

Abstract

Gastroesophageal reflux (GER) occurs during sleep. During sleep time, GER events are caused by transient lower esophageal sphincter (LES) relaxations occurring during arousals from sleep. Sleep-related GER events occur more commonly out of arousals from stage N2 NREM sleep, especially during the first 2 h of the sleep period, and esophageal refluxate clearance is delayed during sleep. Prevalence of sleep-related GER approximates 79 % in GER patients and 25 % of the adult population. Symptoms of sleep-related GER include heartburn, regurgitation, arousals, awakenings, insomnia, unrefreshing sleep, daytime sleepiness, and fatigue. Patients with obstructive sleep apnea commonly have sleep-related GER, and treatment with nasal CPAP improves sleep-related GER. The diagnosis of sleep-related GER is made on clinical grounds; however, esophageal testing is useful in selected patients. Treatment of sleep-related GER includes behavioral techniques and proton pump inhibitors (PPIs). There are less data available that address the role of surgical fundoplication and long-term medical therapy outcomes in sleep-related GER. Hopefully, future research will provide better insight.

Keywords

Sleep-related GER Transient LES relaxations Upper esophageal sphincter Insomnia Sleep quality Arousals Wake time sleepiness Obstructive sleep apnea Nasal CPAP Proton pump inhibitors 

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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Department of Medicine/Division of Pulmonary, Allergy & Critical Care MedicineUniversity of Alabama Hospital, University of Alabama at BirminghamBirminghamUSA

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