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Temporal Relationship Between Night-Time Gastroesophageal Reflux Events and Arousals From Sleep
Kelly Shepherd1,2, James Ockelford1,2, Vijeyadezmi Ganasan1,2
1Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Australia.
The American Journal of Gastroenterology
|May 2, 2020
Summary
Night-time gastroesophageal reflux (nGER) does not cause sleep arousal. Instead, arousals from sleep appear to predispose individuals to nGER events, challenging previous assumptions about this relationship.
Area of Science:
- Gastroenterology
- Sleep Medicine
- Medical Technology
Background:
- Night-time gastroesophageal reflux (nGER) symptoms frequently disrupt sleep.
- Previous research on the nGER-sleep relationship relied on accelerometry, limiting precise temporal analysis.
- High-resolution polysomnography (PSG) offers advanced capabilities for studying sleep and reflux events.
Purpose of the Study:
- To investigate the precise temporal relationship between nGER events and sleep arousal/awakening.
- To utilize in-laboratory PSG for a more accurate assessment than previous methods.
Main Methods:
- Simultaneous 24-hour pH/impedance monitoring and in-laboratory PSG were conducted on 25 participants (18-70 years).
- Analysis focused on the temporal association between nGER events and sleep stages, arousals, or awakenings during the sleep period.
- Data from participants with and without nGER, including those with obstructive sleep apnea (OSA), were analyzed.
Main Results:
- Most nGER events (82%) occurred during sleep epochs classified as wake.
- Arousals or awakenings preceded the majority of nGER events (73/76).
- No significant differences in sleep parameters or OSA severity were found between individuals with and without nGER.
Conclusions:
- Contrary to common assumptions, nGER events do not appear to trigger sleep arousals.
- Sleep arousals and awakenings are more likely to precede and potentially predispose individuals to nGER.
- This finding reframes the understanding of the causal relationship between sleep disturbances and reflux in nGER.
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