Table Info

Table 1.

Normal physiologic changes in the upper GI tract during sleep [10]

Location	Physiologic changes
Oropharynx	Decreased: Salivary secretion and flow Swallowing rate
Esophagus	Decreased: Esophageal peristalsis Esophageal acid clearance Upper esophageal sphincter pressure Perception of intraesophageal stimuli
Stomach	Increased: Gastric acidity Decreased: Gastric emptying

Location

Physiologic changes

Oropharynx

Decreased:

Salivary secretion and flow
Swallowing rate

Esophagus

Decreased:

Esophageal peristalsis
Esophageal acid clearance
Upper esophageal sphincter pressure
Perception of intraesophageal stimuli

Stomach

Increased:

Gastric acidity

Decreased:

Gastric emptying

Note. Adapted with permission from “Sleep and gastrointestinal health,” by D’Souza SM, Fass R, Shibli F, Johnson DA. In: Kryger MH, Roth T, Goldstein CA, editors. Principles and practice of sleep medicine. 7th ed. Amsterdam: Elsevier; 2022. pp. 1557–64 (https://www.us.elsevierhealth.com/principles-and-practice-of-sleep-medicine-2-volume-set-9780323661898.html). © 2022 Elsevier.

Supplementary materials

The supplementary Tables for this article are available at: https://www.explorationpub.com/uploads/Article/file/1001191_sup_1.pdf.

Declarations

Author contributions

DAJ, LS, and NFW: Conceptualization, Methodology, Writing—review & editing, Visualization. AMPD: Conceptualization, Methodology, Validation, Formal analysis, Resources, Writing—original draft, Writing—review & editing, Supervision, Project administration, Visualization, Funding acquisition. EA: Conceptualization, Methodology, Resources, Writing—review & editing, Supervision, Visualization. HD: Methodology, Validation, Formal analysis, Writing—review & editing. ASBP: Validation, Formal analysis, Writing—review & editing, Visualization. All authors read and approved the submitted version.

Conflicts of interest

DAJ is a consultant to Johnson & Johnson Consumer Inc. and ISOThrive. NFW is a consultant to Johnson & Johnson Consumer Inc., Idorsia, Harmony Biosciences, Jazz, and Takeda. HD is an employee of ClinChoice Canada which received funding from Johnson & Johnson Consumer Inc. for the conduct of systematic literature searches and preparation of summaries of identified published literature. ASBP is an employee of Medica Communications, LLC, which received funding from Johnson & Johnson Consumer Inc. for the conduct of systematic literature searches and preparation of summaries of identified published literature. LS is a retired employee of Johnson & Johnson Consumer Inc. and was a consultant to Johnson & Johnson Consumer Inc. through Source One Technical Solutions, LLC. AMPD and EA are employees of Johnson & Johnson Consumer Inc.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Johnson & Johnson Consumer Inc. provided financial support for the study design, conduct of systematic literature searches, preparation of published literature study summaries, and data analysis. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright

References

GBD 2017 Oesophageal Cancer Collaborators. The global, regional, and national burden of oesophageal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2020;5:582–97. [DOI] [PubMed] [PMC]

Fass R, Quan SF, O’Connor GT, Ervin A, Iber C. Predictors of heartburn during sleep in a large prospective cohort study. Chest. 2005;127:1658–66. [DOI] [PubMed]

Gerson LB, Fass R. A systematic review of the definitions, prevalence, and response to treatment of nocturnal gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2009;7:372–8. [DOI] [PubMed]

Tack J, Becher A, Mulligan C, Johnson DA. Systematic review: the burden of disruptive gastro-oesophageal reflux disease on health-related quality of life. Aliment Pharmacol Ther. 2012;35:1257–66. [DOI] [PubMed]

Johnson DA, Ware JC, Vorona RD. Gastroesophageal reflux disease related sleep dysfunction and driving (simulator) impairment: response to treatment with esomeprazole. Gastroenterol Hepatol Open Access. 2017;6:10–4. [DOI]

Reynolds AC, Banks S. Total sleep deprivation, chronic sleep restriction and sleep disruption. Prog Brain Res. 2010;185:91–103. [DOI] [PubMed]

Bonnet MH, Arand DL. Clinical effects of sleep fragmentation versus sleep deprivation. Sleep Med Rev. 2003;7:297–310. [DOI] [PubMed]

St-Onge MP, Grandner MA, Brown D, Conroy MB, Jean-Louis G, Coons M, et al.; American Heart Association Obesity; Diabetes, and Nutrition Committees of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; Stroke Council. Sleep duration and quality: impact on lifestyle behaviors and cardiometabolic health: a scientific statement from the American Heart Association. Circulation. 2016;134:e367–86. [DOI] [PubMed] [PMC]

Kadier K, Qin L, Ainiwaer A, Rehemuding R, Dilixiati D, Du YY, et al. Association of sleep-related disorders with cardiovascular disease among adults in the United States: a cross-sectional study based on national health and nutrition examination survey 2005–2008. Front Cardiovasc Med. 2022;9:954238. [DOI] [PubMed] [PMC]

10.

D’Souza SM, Fass R, Shibli F, Johnson DA. Sleep and gastrointestinal health. In: Kryger MH, Roth T, Goldstein CA, editors. Principles and practice of sleep medicine. 7th ed. Amsterdam: Elsevier; 2022. pp. 1557–64.

11.

Kahrilas PJ, Shaheen NJ, Vaezi MF; American Gastroenterological Association Institute; Clinical Practice and Quality Management Committee. American Gastroenterological Association institute technical review on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135:1392–413.e5. [DOI] [PubMed]

12.

Mittal RK. Montreal, Rome, and Lyon Consensus: Will they resolve the conundrum of gastroesophageal reflux disease. Gastroenterology. 2021;161:1776–9. [DOI] [PubMed]

13.

Choung RS, Saito YA, Schleck CD, Harmsen WS, Zinsmeister AR, Murray JA, et al. The natural history of chronic unexplained gastrointestinal disorders and gastroesophageal reflux over 20 years: a US population-based study. Mayo Clin Proc. 2021;96:563–76. [DOI] [PubMed] [PMC]

14.

Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG Clinical Guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117:27–56. [DOI] [PubMed] [PMC]

15.

Katz PO, Koch FK, Ballard ED, Bagin RG, Gautille TC, Checani GC, et al. Comparison of the effects of immediate-release omeprazole oral suspension, delayed-release lansoprazole capsules and delayed-release esomeprazole capsules on nocturnal gastric acidity after bedtime dosing in patients with night-time GERD symptoms. Aliment Pharmacol Ther. 2007;25:197–205. [DOI] [PubMed]

16.

Fass R. The relationship between gastroesophageal reflux disease and sleep. Curr Gastroenterol Rep. 2009;11:202–8. [DOI] [PubMed]

17.

Johnson DA, Le Moigne A, Hugo V, Nagy P. Rapid resolution of sleep disturbances related to frequent reflux: effect of esomeprazole 20 mg in two randomized, double-blind, controlled trials. Curr Med Res Opin. 2015;31:243–50. [DOI] [PubMed]

18.

Johnson DA, Le Moigne A, Li J, Pollack C, Nagy P. Analysis of clinical predictors of resolution of sleep disturbance related to frequent nighttime heartburn and acid regurgitation symptoms in individuals taking esomeprazole 20 mg or placebo. Clin Drug Investig. 2016;36:531–8. [DOI] [PubMed] [PMC]

19.

Johnson DA, Orr WC, Crawley JA, Traxler B, McCullough J, Brown KA, et al. Effect of esomeprazole on nighttime heartburn and sleep quality in patients with GERD: a randomized, placebo-controlled trial. Aliment Pharmacol Ther. 2005;100:1914–22. [DOI] [PubMed]

20.

Mody R, Bolge SC, Kannan H, Fass R. Effects of gastroesophageal reflux disease on sleep and outcomes. Clin Gastroenterol Hepatol. 2009;7:953–9. [DOI] [PubMed]

21.

Shaker R, Castell DO, Schoenfeld PS, Spechler SJ. Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association. Am J Gastroenterol. 2003;98:1487–93. [DOI] [PubMed]

22.

Liu D, Xu L, Chen L, Hu J, Wu D, Wang G, et al. TRPV1 is a risk factor for sleep disturbance in patients with gastro-oesophageal reflux disease: a case control study. Scand J Gastroenterol. 2023;58:844–55. [DOI] [PubMed]

23.

Yamasaki T, Quan SF, Fass R. The effect of sleep deficiency on esophageal acid exposure of healthy controls and patients with gastroesophageal reflux disease. Neurogastroenterol Motil. 2019;31:e13705. [DOI] [PubMed]

24.

Kurin M, Shibli F, Kitayama Y, Kim Y, Fass R. Sorting out the relationship between gastroesophageal reflux disease and sleep. Curr Gastroenterol Rep. 2021;23:15. [DOI] [PubMed]

25.

Jung HK, Choung RS, Talley NJ. Gastroesophageal reflux disease and sleep disorders: evidence for a causal link and therapeutic implications. J Neurogastroenterol Motil. 2010;16:22–9. [DOI] [PubMed] [PMC]

26.

Orr WC, Heading R, Johnson LF, Kryger M. Review article: sleep and its relationship to gastro-oesophageal reflux. Aliment Pharmacol Ther. 2004;20:39–46.

27.

Diamant NE. Pathophysiology of gastroesophageal reflux disease. GI Motility Online. 2006.

28.

Stacher G, Presslich B, Stärker H. Gastric acid secretion and sleep stages during natural night sleep. Gastroenterology. 1975;68:1449–5. [PubMed]

29.

Parekh, PJ, Oldfield EC, Johnson DA. Wake-up call to clinicians: the impact of sleep dysfunction on gastrointestinal health and disease. J Clin Gastroenterol. 2018;52:194–203. [DOI] [PubMed]

30.

Yi CH, Lei WY, Hung JS, Liu TT, Orr WC, Chen CL. Sleep disturbance and enhanced esophageal capsaicin sensitivity in patients with gastroesophageal reflux disease. J Gastroenterol Hepatol. 2016;31:1940–5. [DOI] [PubMed]

31.

Schey R, Dickman R, Parthasarathy S, Quan SF, Wendel C, Merchant J, et al. Sleep deprivation is hyperalgesic in patients with gastroesophageal reflux disease. Gastroenterology. 2007;133:1787–95. [DOI] [PubMed]

32.

Hägg SA, Emilsson ÖI, Franklin K, Janson C, Lindberg E. Nocturnal gastroesophageal reflux increases the risk of daytime sleepiness in women. Sleep Med. 2019;53:94–100. [DOI] [PubMed]

33.

Johnson DA, Crawley JA, Hwang C, Brown K. Clinical trial: esomeprazole for moderate-to-severe nighttime heartburn and gastro-oesophageal reflux disease-related sleep disturbances. Aliment Pharmacol Ther. 2010;32:182–90. [DOI] [PubMed]

34.

Fass R, Johnson DA, Orr WC, Han C, Mody R, Stern KN, et al. The effect of dexlansoprazole MR on nocturnal heartburn and GERD-related sleep disturbances in patients with symptomatic GERD. Am J Gastroenterol. 2011;106:421–31. [DOI] [PubMed]

35.

Dubois RW, Aguilar D, Fass R, Orr WC, Elfant AB, Dean BB, et al. Consequences of frequent nocturnal gastro-oesophageal reflux disease among employed adults: symptom severity, quality of life and work productivity. Aliment Pharmacol Ther. 2007;25:487–500. [DOI] [PubMed]

36.

Kahrilas PJ, Howden CW, Wernersson B, Denison H, Nuevo J, Gisbert JP. Impact of persistent, frequent regurgitation on quality of life in heartburn responders treated with acid suppression: a multinational primary care study. Aliment Pharmacol Ther. 2013;37:1005–10. [DOI] [PubMed]

37.

Yadlapati R, Gyawali CP, Pandolfino JE; CGIT GERD Consensus Conference Participants. AGA clinical practice update on the personalized approach to the evaluation and management of GERD: expert review. Clin Gastroenterol Hepatol. 2022;20:984–94.e1. [DOI] [PubMed] [PMC]

38.

Mann SG, Murakami A, McCarroll K, Rao AN, Cottrell J, Mehentee J, et al. Low dose famotidine in the prevention of sleep disturbance caused by heartburn after an evening meal. Aliment Pharmacol Ther. 1995;9:395–401. [DOI] [PubMed]

39.

Rackoff A, Agrawal A, Hila A, Mainie I, Tutuian R, Castell DO. Histamine-2 receptor antagonists at night improve gastroesophageal reflux disease symptoms for patients on proton pump inhibitor therapy. Dis Esophagus. 2005;18:370–3. [DOI] [PubMed]

40.

Katzka DA, Kahrilas PJ. Advances in the diagnosis and management of gastroesophageal reflux disease. BMJ. 2020;371:m3786. [DOI] [PubMed]

41.

Gu C, Olszewski T, King KL, Vaezi MF, Niswender KD, Silver HJ. The effects of modifying amount and type of dietary carbohydrate on esophageal acid exposure time and esophageal reflux symptoms: a randomized controlled trial. Am J Gastroenterol. 2022;117:1655–67. [DOI] [PubMed] [PMC]

42.

Kim JS, Seo SI, Kang SH, Lee SK, Kim AR, Park HW, et al. Effects of tegoprazan versus esomeprazole on nighttime heartburn and sleep quality in gastroesophageal reflux disease: a multicenter double-blind randomized controlled trial. J Neurogastroenterol Motil. 2023;29:58–64. [DOI] [PubMed] [PMC]

43.

Gagliardi GS, Shah AP, Goldstein M, Denua-Rivera S, Doghramji K, Cohen S, et al. Effect of zolpidem on the sleep arousal response to nocturnal esophageal acid exposure. Clin Gastroenterol Hepatol. 2009;7:948–52. [DOI] [PubMed]

44.

Jha LK, Fass R, Gadam R, Maradey-Romero C, Nasrollah L, Hershcovici T, et al. The effect of ramelteon on heartburn symptoms of patients with gastroesophageal reflux disease and chronic insomnia: a pilot study. J Clin Gastroenterol. 2016;50:e19–24. [DOI] [PubMed]

45.

Thor PJ, Krolczyk G, Gil K, Zurowski D, Nowak L. Melatonin and serotonin effects on gastrointestinal motility. J Physiol Pharmacol. 2007;58 Suppl 6:97–103. [PubMed]

46.

Konturek SJ, Konturek PC, Brzozowski T, Bubenik GA. Role of melatonin in upper gastrointestinal tract. J Physiol Pharmacol. 2007;58 Suppl 6:23–52. [PubMed]

47.

Klupińska G, Wiśniewska-Jarosińska M, Harasiuk A, Chojnacki C, Stec-Michalska K, Błasiak J, et al. Nocturnal secretion of melatonin in patients with upper digestive tract disorders. J Physiol Pharmacol. 2006;57 Suppl 5:41–50. [PubMed]

48.

Majka J, Wierdak M, Brzozowska I, Magierowski M, Szlachcic A, Wojcik D, et al. Melatonin in prevention of the sequence from reflux esophagitis to Barrett’s esophagus and esophageal adenocarcinoma: experimental and clinical perspectives. Int J Mol Sci. 2018;19:2033. [DOI] [PubMed] [PMC]

49.

Centers for Disease Control and Prevention (CDC). Drowsy driving — 19 states and the district of Columbia, 2009–2010. MMWR Morb Mortal Wkly Rep. 2013;61:1033–7. [PubMed]

50.

Sontag SJ, Sonnenberg A, Schnell TG, Leya J, Metz A. The long-term natural history of gastroesophageal reflux disease. J Clin Gastroenterol. 2006;40:398–404. [DOI] [PubMed]

51.

Agrawal A, Castell D. GERD is chronic but not progressive. J Clin Gastroenterol. 2006;40:374–5. [DOI] [PubMed]

52.

Eusebi LH, Telese A, Cirota GG, Haidry R, Zagari RM, Bazzoli F, et al. Effect of gastro-esophageal reflux symptoms on the risk of Barrett’s esophagus: a systematic review and meta-analysis. J Gastroenterol Hepatol. 2022;37:1507–16. [DOI] [PubMed] [PMC]

53.

Medic G, Wille M, Hemels ME. Short- and long-term health consequences of sleep disruption. Nat Sci Sleep. 2017;9:151–61. [DOI] [PubMed] [PMC]

54.

Ikegami K, Ogyu S, Arakomo Y, Suzuki K, Mafune K, Hiro H, et al. Recovery of cognitive performance and fatigue after one night of sleep deprivation. J Occup Health. 2009;51:412–22. [DOI] [PubMed]

55.

Ochab JK, Szwed J, Oleś K, Bereś A, Chialvo DR, Domagalik A, et al. Observing changes in human functioning during induced sleep deficiency and recovery periods. PLoS One. 2021;16:e0255771. [DOI] [PubMed] [PMC]