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Grand Rounds

Does Sleeping Position Matter for Nocturnal Gastroesophageal Reflux?

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BACKGROUND AND PURPOSE:

  • Schuitenmaker et al. (The American Journal of Gastroenterology, 2022) investigated the effect of spontaneous sleep positions on the occurrence of nocturnal gastroesophageal reflux (GERD)

METHODS:

  • Participants
    • Patients referred for ambulatory pH-impedance reflux monitoring with an esophageal acid exposure ≥ 0.5% or higher during the supine position
  • Exposure
    • Sleep position: Left | Right | Supine | Prone
  • Study design
    • During each nocturnal reflux episode, the following measurements were assessed
      • Composition (liquid or mixed liquid-gas)
      • Type (acid or weakly acid)
      • Proximal extent of reflux episode and sleep position
    • Medians and 25th to 75th percentile (P25 to P75) ranges used
  • Primary outcome
    • Esophageal acid exposure time
    • Acid clearance time

RESULTS:

  • 57 patients
  • There was a significantly shorter acid exposure time with left side sleeping position vs right side or supine positioning
    • Left: Median 0.0% (P25 to P75, 0.0 to 3.0)
    • Right: Median 1.2% (P25 to P75, 0.0 to 7.5)
      • P=0.022
    • Supine: Median 0.6% (P25 to P75, 0.0 to 8.3)
      • P=0.022
  • The esophageal acid clearance time was also significantly shorter in the left side position vs right side or supine positioning
    • Left: Median 35 (P25 to P75, 16 to 115) seconds
    • Right: Median 90 (P25 to P75, 26 to 250) seconds
      • P=0.002
    • Supine: Median 76 (P25 to P75, 22 to 257) seconds
      • P=0.030

CONCLUSION:

  • Compared with sleeping on the right side, or the back, sleeping on the left side was associated with significantly shorter nocturnal esophageal acid exposure time and faster esophageal acid clearance

Learn More – Primary Sources:

Associations Between Sleep Position and Nocturnal Gastroesophageal Reflux: A Study Using Concurrent Monitoring of Sleep Position and Esophageal pH and Impedance

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Related ObG Topics:

Gastroesophageal Reflux Disease: From Diagnosis to Treatment
Could Esomeprazole Prolong Pregnancy for Women with Preterm Preeclampsia?
Results from the MiNESS Trial: Does Supine vs Left-Sided Sleeping Position Impact Risk of Stillbirth?

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