Treating nighttime heartburn improves sleep and boosts quality of life

Sep 1 2005

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.