Esophageal reflux disease proton pump inhibitor therapy impact upon sleep disturbance

The use of proton pump inhibitors improves the sleep and daytime quality of life for sufferers of gastroesophageal reflux disease, according to a systematic literature review in the April 2012 issue of Otolaryngology–Head and Neck Surgery.

A 2003 Gallup survey linked gastresophageal heartburn with frequent sleep disturbances. Proton pump inhibitors (PPIs) have proven to be an effective treatment therapy and there are established criteria for treating reflux. However, there are no well-established clinical guidelines on how to treat the sleep disturbances with the resulting quality of life issues.

The review's objective was to evaluate the "impact of PPI treatment of gastroesophageal reflux disease on sleep disturbance—related outcomes."

The authors performed a systematic literature review in PubMed, Web of Science, and the Cochrane Library of all randomized placebo-controlled clinical trials from 1989 (when omeprazole became available) to October 2011. Additional relevant publications were identified based on the articles' citations.

The search strategy identified all randomized placebo-controlled clinical trials published in English; both proton pump inhibitor use and outcome measures of sleep disturbance were reported for esophageal reflux disease patients. Using a preestablished systematic review protocol and data extraction format, four coauthors independently reviewed all articles.

Based on the review findings, the authors state: "The existing evidence supports the use of PPI medications as a treatment to improve esophageal reflux disease symptoms and associated quality-of-life sleep disturbance-related outcomes."

"Although the improvements are likely secondary gains from reduction or elimination of nocturnal GERD symptoms, further research appears warranted to evaluate PPI treatment impact on polysomnography outcomes, as well as to examine the relationship of polysomnography vs. nonpolysomnography outcomes, for GERD patients with sleep disturbance and sleep-disordered breathing," they added.