Sma 5-04 Rev

138. 9. Guda N, Partington S, Vakil N. Symptomatic gastrooesophageal reflux, arousals and sleep quality in patients undergoing polysomnography for possible obstructive sleep apnoea. Aliment Pharm Ther. 2004;20:1153-1159.Indeed, results of a recent Internet survey showed thatGERD-related symptom severity was strongly associatedwith work impairment, and that nighttime GERD wasassociated with substantially greater work impairment,as was symptom severity. [8] In a smaller study usingpolysomnography to define sleep parameters rabepra-zole 20mg qd was shown to improve subjective sleepmeasures without any change in the objective sleepmeasures. [6]). Pantoprazole is the only PPI with anindication for nighttime heartburn, but there are nooutcome studies on treated patients with nighttimeheartburn and sleep disorders.) Other lifestyle measuresmay also be helful in controlling nighttime GER, andthese are noted in Table 1. Perhaps the most importantis to avoid sleeping within 2 hours of eating a meal.The gastric distension resulting from a meal will, asnoted earlier, predispose to the occurrence of transientdecreases of the LES and subsequent GER. OBSTRUCTIVE SLEEP APNEAPatients with obstructive sleep apnea (OSA) sharerisk factors for GERD such as obesity. Heartburn isa symptom commonly observed in patients withobstructive sleep apnea (OSA). Patients with bothGER and OSA have been shown to have significantlypoorer quality of life compared with patients with OSAalone. [9] It is clinically well established that OSA isassociated with a profound degree of daytime sleepi-ness, depression, and irritability — all of which arefactors that weigh heavily in diminishing the qualityof life. GER exacerbates to an even greater degree thequality of life in this patient population (i.e., those withsleep disorders). CONCLUDING REMARKSIn conclusion, it appears that the occurrence ofnighttime heartburn is a symptom that clearly mitigatesquality of life and work performance. Patients withnighttime heartburn consistently report that these night-time symptoms disturb them more than their daytimeheartburn, and the resultant disturbance in sleep andthe impaired daytime performance takes its toll interms of the quality of daily life in these patients. It isalso evident that although there are many causes ofsleepiness, nighttime heartburn is indeed associatedwith reports of disturbed sleep, and in a majority ofsuch patients, sleep disturbances and quality of life canbe markedly improved by eliminating the symptoms ofnighttime heartburn. SMA