Orr W C, Heading R, Johnson L F, Kryger M
Lynn Health Science Institute, Oklahoma City, Oklahoma 73112, USA.
Aliment Pharmacol Ther. 2004 Dec;20 Suppl 9:39-46. doi: 10.1111/j.1365-2036.2004.02239.x.
Gastro-oesophageal reflux disease (GERD) is among the most common gastrointestinal conditions in the USA. For most symptomatic patients, reflux events occur during both daytime and night-time hours. Whereas daytime reflux events tend to be frequent but brief, reflux events that occur during sleep are comparatively less frequent but significantly longer. Longer oesophageal acid-clearance and acid-mucosal contact times during sleep are at least partly due to several physiological changes associated with sleep, including dramatic declines in saliva production and frequency of swallowing, decreased conscious perception of heartburn and consequent arousal and clearance behaviours, and slower gastric emptying. 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. Recognition and treatment of night-time GERD are important because it can be associated with decreased quality of life (including sleep disruption) and increased risk of serious oesophageal and respiratory complications.
胃食管反流病（GERD）是美国最常见的胃肠道疾病之一。对于大多数有症状的患者来说，反流事件在白天和夜间都会发生。白天的反流事件往往频繁但短暂，而睡眠期间发生的反流事件相对较少，但持续时间明显更长。睡眠期间食管酸清除和酸与黏膜接触时间延长至少部分归因于与睡眠相关的几种生理变化，包括唾液分泌和吞咽频率显著下降、对烧心的意识感知降低以及随之而来的觉醒和清除行为，以及胃排空减慢。阻塞性睡眠呼吸暂停综合征和肥胖似乎使一些患者易患夜间GERD，这两种情况中的任何一种都可能有助于识别有GERD相关症状的患者。识别和治疗夜间GERD很重要，因为它可能与生活质量下降（包括睡眠中断）以及严重食管和呼吸道并发症风险增加有关。
