Digestive Health Institute, Division of Gastroenterology and Hepatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
Curr Gastroenterol Rep. 2021 Aug 2;23(9):15. doi: 10.1007/s11894-021-00815-4.
Gastroesophageal reflux disease is one of the most common conditions encountered by primary care physicians, gastroenterologists, foregut surgeons and otolaryngologists. While approximately 50% of patients experience nocturnal reflux symptoms, the relationship between gastroesophageal reflux disease and sleep is often overlooked. The aim of this review is to provide an update on the current understanding of this relationship and its clinical implications. Recent studies pertaining to the association between GERD and sleep with focus on sleep disturbances, obstructive sleep apnea, extraesophageal manifestations of GERD and treatment are discussed.
There is a close relationship between GERD and sleep disturbances, but the nature of this relationship remains to be elucidated. Similarly, new data supports the association between GERD and obstructive sleep apnea, but whether this association is independent of confounding risk factors remains unresolved. Extraesophageal manifestations due to nocturnal GERD are primarily respiratory and can be explained by microaspiration and vagally-induced bronchospasm. Treatment of nocturnal GERD, both pharmacologically and surgically, improves sleep quality. Conversely, pharmacologic treatment of sleep disorders can improve nocturnal GERD symptoms. There is a bi-directional relationship between GERD and sleep. GERD is associated with various sleep disturbances. Sleep deficiency can exacerbate GERD. There is an association between extraesophageal manifestations and nocturnal GERD. Treatment directed towards GERD can improve sleep experience, and treatment directed to improve sleep can improve GERD symptoms.
胃食管反流病（GERD）是初级保健医生、胃肠病学家、前肠外科医生和耳鼻喉科医生最常遇到的病症之一。尽管约有 50%的患者存在夜间反流症状，但 GERD 与睡眠之间的关系往往被忽视。本文旨在提供 GERD 与睡眠之间关系的最新认识及其临床意义的更新。本文重点讨论了与 GERD 和睡眠相关的最新研究，包括睡眠障碍、阻塞性睡眠呼吸暂停、GERD 的食管外表现和治疗。
GERD 和睡眠障碍之间存在密切关系，但这种关系的性质仍有待阐明。同样，新数据支持 GERD 与阻塞性睡眠呼吸暂停之间的关联，但这种关联是否独立于混杂的危险因素仍未解决。由于夜间 GERD 引起的食管外表现主要是呼吸系统，可以通过微吸入和迷走神经诱导的支气管痉挛来解释。夜间 GERD 的药物和手术治疗均可改善睡眠质量。相反，睡眠障碍的药物治疗可以改善夜间 GERD 症状。GERD 和睡眠之间存在双向关系。GERD 与各种睡眠障碍有关。睡眠不足会加重 GERD。食管外表现与夜间 GERD 之间存在关联。针对 GERD 的治疗可以改善睡眠体验，针对改善睡眠的治疗可以改善 GERD 症状。
