Losing sleep over heartburn? Treating nighttime heartburn improves sleep and boosts quality of life

Main Category: Sleep / Sleep Disorders / Insomnia
Article Date: 03 Sep 2005 - 1:00 PDT

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The first major multi-center, randomized, double-blind, placebo-controlled trial addressing therapy for gastroesophageal reflux disease (GERD) related sleep disorders is published in the September issue of The American Journal of Gastroenterology. This study demonstrated that effective acid suppression therapy with a proton pump inhibitor (PPI), either 20 mgs or 40 mgs of esomeprazole, relieved nighttime heartburn symptoms and GERD-related sleep disturbances, which significantly improved sleep quality and thereby improved work productivity.

The researchers found that nighttime heartburn was relieved in 53.1 percent, 50.5 percent and 12.7 percent of patients who received esomeprazole 40 mg, esomeprazole 20 mg and placebo, respectively. Additionally, GERD-related sleep disturbances resolved in significantly more patients who received therapy than those who received placebo. The high percentage of patients with resolutions of sleep disturbances in the current trial was both statistically and clinically significant.

"Sleep problems are extremely common in patients with GERD and are often unrecognized," said lead author David A. Johnson, M.D., FACG, Professor of Medicine and Chief of Gastroenterology at Eastern Virginia Medical School who serves as the Vice President of the American College of Gastroenterology. For those with frequent and moderate-to-severe symptoms, GERD has a significant negative impact on sleep. "Anyone who's had a poor night's rest knows how much that impacts their performance the next day. We found that nighttime heartburn is a treatable condition that responds to effective, acid-suppressive medical therapy such as esomeprazole."

Additionally, an estimate by the American College of Gastroenterology based on findings from this study reveals that U.S. workers who frequently suffer from moderate-to-severe nighttime heartburn symptoms cost the U.S. economy $1,920,528,315 per week in paid hours of lost productivity.

According to Dr. Johnson, "Physicians treating patients with acid reflux therefore need to ask about sleep problems and furthermore to ask how patients feel when they wake up the next day. Daytime fatigue, irritability, concentration problems may all suggest a problem with restful sleep. Appropriate recognition of this will lead to appropriate therapy." He continued, "Sleep quality should be included as an important goal for optimal disease management of GERD. Even more so in a time of emphasis on quality management and achieving the best outcomes in medical care, this study demonstrates that appropriate treatment for GERD is an investment which has profound quality benefits for patients and economic benefits for employers."

According to the American College of Gastroenterology, approximately 20 percent of U.S. adults suffer from weekly heartburn symptoms. The ACG, using data from a Gallup poll, estimates that 79 percent of heartburn sufferers have nighttime symptoms, of whom 50 percent have symptoms that are moderate to severe.

Visit the American Journal of Gastroenterology Web site at blackwellpublishing.com/ajg.

David A. Johnson, M.D., FACG is Professor of Medicine and Chief of Gastroenterology at Eastern Virginia Medical School. He serves as the Vice President of the American College of Gastroenterology and is key opinion leader for the US and internationally on gastroesophageal reflux disease. For questions and interviews, please see the contacts above.

About the Journal

The clinical journal in gastroenterology: The American Journal of Gastroenterology meets the day-to-day demands of clinical practice. Aimed at practicing clinicians, the journal's articles deal directly with the disorders seen most often in patients. The journal brings a broad-based, interdisciplinary approach to the study of gastroenterology, including articles reporting on current observations, research results, methods of treatment, drugs, epidemiology, and other topics relevant to clinical gastroenterology.

About the American College of Gastroenterology

Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of almost 9,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical and cost-effective health care to gastroenterology patients.

About Blackwell Publishing

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