Open AccessReflux Disease and Proton Pump Inhibitor Therapy: Impact upon Sleep Disturbance
Author(s) -
Regenbogen Elliot,
Helkin Alex,
Georgopoulos Rachel,
Vasu Tajender,
Shroyer A. Laurie W.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451438a273
Subject(s) - placebo , medicine , proton pump inhibitor , meta analysis , sleep disorder , gerd , reflux , polysomnography , randomized controlled trial , disease , psychiatry , alternative medicine , pathology , apnea , cognition
Objective To perform a systematic literature review that evaluates the impact of proton pump inhibitor treatment of gastroesophageal reflux disease upon sleep disturbance‐related outcomes. Method PubMed, Web of Science, and Cochrane databases were searched from 1989 to present, identifying all radomized placebo‐controlled clinical trials where both proton pump inhibitor use and outcome measures of sleep disturbance were reported for esophageal refludisease patients. Using pre‐established systematic review protocol 4 co‐authors independently reviewed all articles. Results The original search idetified 20 articles; 9 were not directly relevant, and 3 were not placebo controlled. Sample sizes varied from 15 to 642; mean age was 47.4 ± 4.56; mean body mass index was 29.4 ± 2.90; the proportion of women varied widely across studies. Esopmeprazole was studied most frequently. Over 50% of publications permitted rescue antacids. Two studies reported polysomnography outcomes, without statistically significant improvement. All studies reported nonpolysomnography outcomes; 7 identified statistically significant improvements demonstrating drug treatment superiority over placebo. Conclusion The existing evidence supports the use of proton pump inhibitor as a treatment for esophageal reflux disease to improve quality of life sleep disturbance‐related outcomes. While variability in treatments and outcomes prevented direct comparisons, this conclusion appears robust for 7 of 8 studies, including the highest 3 quality studies.