Gastroesophageal reflux disease: Evidence for influence on sleep and quality of life

This review addresses current advances in gastroesophageal reflux disease (GERD) and its influence on sleep and health-related quality of life (QOL). Sleep difficulties are highly prevalent among adults with GERD, especially those who experience nighttime symptoms. These sleep difficulties result in substantial costs to the health care system by increasing provider visits. Because continued sleep disruption leads to increased daytime sleepiness and fatigue, nocturnal heartburn can reduce work productivity, as well as reduce function when performing normal daily activities. The continued presence of nocturnal symptoms in routine medical treatment is strongly associated with decreases in health-related quality of life. There is a greater loss of productivity to the employer and poorer health-related QOL (HRQOL) for the patient. Obstructive sleep apnea syndrome and obesity seem to predispose some patients to nocturnal GERD, and the presence of either of these conditions may help to identify patients with symptoms consistent with GERD. Appropriate management of GERD must include treatment of nighttime reflux symptoms that affect difficulty in both initiating and maintaining sleep.