Left lateral sleep position may alleviate nocturnal esophageal acid exposure, symptoms
Among patients who experience nocturnal gastroesophageal reflux, the left lateral decubitus sleep position correlated with significantly shorter esophageal acid exposure time and faster esophageal acid clearance, according to research.
“Up to 80% of the patients with gastroesophageal reflux disease experience burdensome symptoms at night, which can have a negative effect on sleep quality,” Jeroen M. Schuitenmaker, MD, of the department of gastroenterology and hepatology at Amsterdam University Medical Centers, and colleagues wrote in the American Journal of Gastroenterology. “The aim of this study was to investigate the effect of spontaneous sleep positions on the occurrence of nocturnal gastroesophageal reflux by combining pH-impedance and sleep position monitoring in a large prospective cohort of patients with reflux symptoms.”
Schuitenmaker and colleagues included 57 patients who were referred for ambulatory pH-impedance reflux monitoring with supine esophageal acid exposure of 0.5% or higher. They used a sleep position measurement device to measure concurrent sleep positions (left, right, supine and prone) and evaluated composition, type and proximal extent of reflux episode and sleep position for each nocturnal gastroesophageal reflux episode.
Researchers observed a shorter acid exposure time in the left lateral position (median 0%) vs. right lateral (median 1.2%, P = .022) and supine positions (median 0.6%, P = .022). They also observed a shorter esophageal acid clearance time in the left lateral decubitus position (median 35 seconds) compared with supine (median 76 seconds, P = .030) and right lateral positions (median 90 seconds, P = .002).
“Findings of this study suggest that when the left lateral decubitus sleeping position can be promoted, patients will have a substantially lower acid exposure time, which may result in less esophageal damage and fewer nocturnal reflux symptoms,” Schuitenmaker, told Healio. “Indeed, our novel study shows that sleep positional therapy using an electronic wearable device promotes sleeping in the left lateral decubitus position and effectively alleviates nocturnal reflux symptoms compared with sham treatment.”