Netherlands Study on Sleep Position and Gastroesophageal Reflux

A recent study in the American Journal of Gastroenterology showed that the left lateral decubitus position is related to significantly shorter nocturnal esophageal acid exposure time and faster esophageal acid clearance.

Jeroen M. Schuitenmaker, University Medical Centers Amsterdam, Amsterdam, the Netherlands, and colleagues conducted this study with the objective to investigate the effect of spontaneous sleep positions on the occurrence of nocturnal gastroesophageal reflux.

For this purpose, the researchers designed a prospective observational study in which they measured the concurrent sleep position in patients referred for ambulatory pH-impedance reflux monitoring by using a sleep position measurement device (measuring left, right, supine, and prone positions). Fifty-seven patients were included.

The study included a total of 215 consecutive adult patients with an indication for ambulatory pH-impedance monitoring for evaluation of reflux symptoms between December 2019 and March 2021. Those with a history of gastric surgery, esophageal surgery, or other esophageal disorders (such as achalasia and esophageal atresia) were excluded.

Study Findings

• A significantly shorter acid exposure time was observed in the left (median 0.0%, P25–P75), compared with the right lateral position (median 1.2%, 0.0%–7.5%) and the supine position (median 0.6%, 0.00%–8.3%).
• The esophageal acid clearance time was significantly shorter in the left lateral decubitus position (median 35 seconds, 16–115 seconds), compared with the supine (median 76 seconds, 22–257 seconds) and right lateral positions (median 90 seconds, 26–250 seconds).

"The left lateral decubitus position is associated with significantly shorter nocturnal esophageal acid exposure time and faster esophageal acid clearance compared with the supine and right lateral decubitus positions," concluded the authors.

Reference

Schuitenmaker, Jeroen M. MD; van Dijk, Mitch MD; Oude Nijhuis, Renske A.B. MD; Smout, André J.P.M. MD, PhD; Bredenoord, Albert J. MD, PhD. Associations Between Sleep Position and Nocturnal Gastroesophageal Reflux: A Study Using Concurrent Monitoring of Sleep Position and Esophageal pH and Impedance, The American Journal of Gastroenterology: December 20, 2021 - Volume - Issue - 10.14309/ajg.0000000000001588 doi: 10.14309/ajg.0000000000001588