“Silent reflux” may cause sleep disturbance
Gastric reflux that doesn’t cause heartburn may still lead to significant sleep disturbances, resulting in daytime sleepiness and fatigue, investigators reported this week at the annual meeting of the American College of Gastroenterology in Honolulu.
“For some time we have noted that acid in the esophagus that occurs when people are asleep will produce a brief arousal response, and that if it occurs multiple times over the course of a night it can produce significant sleep disruption,” said lead investigator Dr. William C. Orr.
This raises the question, he said, of whether people with unexplained daytime sleepiness and fatigue are having nighttime reflux without symptoms of heartburn.
To investigate, Orr, from the Lynn Health Sciences Institute in Oklahoma City, and his colleagues evaluated 81 subjects with sleep problems but no complaints of heartburn.
After conducting sleep evaluations and esophageal acidity monitoring on two separate occasions, the researchers found that 26 percent had reflux. Ninety-four percent of recorded reflux events were associated with sleep arousal or awakening.
Orr advised that people who have sleep problems but no other obvious explanation for daytime sleepiness or fatigue, such as depression or sleep apnea, should talk to their doctors about checking to see if they have gastroesophageal reflux.
He recommends medication to cut down gastric acid production for patients with reflux, even if there are no symptoms of heartburn.
The study was sponsored by Astra Zeneca.
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