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Nocturnal Acid Reflux

At night, acid reflux can cause distress to patients resulting from symptoms such as heartburn. It may also affect the sleep quality of patients or trigger insomnia. Besides prescription medicine, clinical studies have shown that sleeping on the left side with the upper body raised can also improve acid reflux.

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The prevalence of GERD is 3.8%. It is estimated 200,000 adults in Hong Kong have weekly GERD symptoms

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79% GERD patients reported experiencing heartburn at night

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About 30% GERD patients remain symptomatic while receiving daily medication

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Nocturnal Acid Reflux

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Acid reflux, also known as gastroesophageal reflux. When acid reflux becomes a long-term condition and happens more frequently, it may become Gastroesophageal Reflux Disease (GERD). GERD is a chronic digestive system disorder.
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Stomach acid will easily spill into the esophagus when sleeping on our backs. Gastric emptying will be slower and saliva secretion which can neutralize the stomach acid will decrease during sleep. Hence, acid reflux is more likely to occur at night during sleep.
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The most common symptom of GERD is heartburn. Unlike the stomach lining, the structure of the esophagus cannot withstand high level of acidity. When stomach acid back flows into the esophagus, the patient will feel a burning sensation spreading from the stomach to the throat and chest cavity. Other symptoms include chest pain, abdominal distension, acid regurgitation, persistent sore throat or coughing, pain swallowing, and a hoarse voice.
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Nocturnal Gastroesophageal Reflux (nGER) not only affects a patient's sleep quality but may also irritate or even damage the esophageal lining. In the long term, it may cause esophagitis, esophageal ulcer, and increase the risk of esophageal cancer.
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Poor living habits are a vital cause of gastroesophageal reflux. Hormonal changes during pregnancy can also easily trigger episodes of refluxes. To treat GERD, taking prescription medicine is currently the first line of treatment. Patients also need to create new habits by avoiding meals 2-3 hours before bedtime and taking more frequent meals with smaller portions. They also need to control their weight and avoid wearing tight clothes that may compress their stomach.
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Clinical studies showing that among patients diagnosed with Obstructive Sleep Apnea (OSA), about 60% have Nocturnal Gastroesophageal Reflux (nGER), and treatment with CPAP decreases about half of the frequency of nGER symptoms.
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Learn more about the solutions for nighttime acid reflux: Reflux Relief Pillow, Therapeutic Body Pillow.

The information above is for reference only, you should consult your doctor if you have any health concern.

 

References: [1] Person E, Rife C, Freeman J, Clark A, Castell DO. A Novel Sleep Positioning Device Reduces Gastroesophageal Reflux: A Randomized Controlled Trial. J Clin Gastroenterol. 2015;49(8):655-659. [2] Tan VP, Wong BC, Wong WM, et al. Gastroesophageal Reflux Disease: Cross-Sectional Study Demonstrating Rising Prevalence in a Chinese Population. J Clin Gastroenterol. 2016;50(1):e1-e7. [3] Shaker R, Castell DO, Schoenfeld PS, Spechler SJ. Nighttimeheartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf ofthe American Gastroenterological Association. Am J Gastroenterol. 2003;98(7):1487-1493. [4] Vaezi MF, Fass R, Vakil N, et al. IW-3718 Reduces HeartburnSeverity in Patients With Refractory Gastroesophageal Reflux Disease in a Randomized Trial. Gastroenterology. 2020;158(8):2093-2103. [5] Green BT, Broughton WA, O'Connor JB. Marked improvement in nocturnal gastroesophageal reflux in a large cohort of patients with obstructive sleep apnea treated with continuous positive airwaypressure. Arch Intern Med. 2003;163(1):41-45.