title: Consequences of frequent nocturnal gastro-oesophageal reflux disease among employed adults: symptom severity, quality of life and work productivity.
abstract: BACKGROUND
  Effects of frequent nocturnal symptoms of gastro-oesophageal reflux disease (GERD-FNS) on health-related quality of life (HRQOL) and work productivity are not well documented.
  
  
  OBJECTIVE
  To assess symptom severity, production loss, and HRQOL among employed adults with and without GERD-FNS.
  
  
  METHODS
  Using several validated outcome measures in a web survey design, GERD was pre-specified as GERD Symptom and Medication Questionnaire score >9, and > or =1 episode of heartburn or acid regurgitation during the preceding week. GERD-FNS patients were those reporting > or =2 symptom-nights during the previous week; their outcomes were compared with those of patients having minimal or no nocturnal symptoms (GERD-NNS) and vs. non-GERD controls.
  
  
  RESULTS
  Data were collected from 1002 GERD patients (476 GERD-FNS, 526 GERD-NNS) and 513 controls. Severe symptoms were more common, sleep abnormalities were more frequent (P < 0.0001) and SF-36 scores lower (P < 0.05, all scores) among GERD-FNS patients vs. GERD-NNS patients. GERD-related work loss was greater among those with GERD-FNS vs. GERD-NNS (P < 0.0001). Work loss and functional limitations were more pronounced when comparing GERD-FNS cases vs. non-GERD controls.
  
  
  CONCLUSIONS
  Employed adults with frequent nocturnal GERD report more severe symptoms, and are associated with impaired sleep, HRQOL and work productivity compared with controls and patients with minimal or no nocturnal symptoms.
authors.affiliation: Cerner LifeSciences, Los Angeles, CA, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: Dubois
authors.forename: D
authors.initials: D
authors.lastname: Aguilar
authors.forename: R
authors.initials: R
authors.lastname: Fass
authors.forename: W C
authors.initials: WC
authors.lastname: Orr
authors.forename: A B
authors.initials: AB
authors.lastname: Elfant
authors.forename: B B
authors.initials: BB
authors.lastname: Dean
authors.forename: A S
authors.initials: AS
authors.lastname: Harper
authors.forename: H T
authors.initials: HT
authors.lastname: Yu
authors.forename: G Y
authors.initials: GY
authors.lastname: Melmed
authors.forename: R
authors.initials: R
authors.lastname: Lynn
authors.forename: A
authors.initials: A
authors.lastname: Singh
authors.forename: M
authors.initials: M
authors.lastname: Tedeschi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001294:Attitude to Health; D004526:Efficiency; D005260:Female; D005764:Gastroesophageal Reflux / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires