Increased oesophageal acid exposure at the beginning of the recumbent period is primarily a recumbent-awake phenomenon.
BACKGROUND
A significant increase in oesophageal acid exposure during early recumbent period has been demonstrated.


OBJECTIVE
To determine if acid reflux during the early recumbent period occurs in the recumbent-asleep or recumbent-awake period using a novel integrative actigraphy and pH programme.


METHODS
Thirty-nine subjects with heartburn at least three times a week were included. Subjects underwent pH testing concomitantly with actigraphy. Simultaneously recorded actigraphy and pH data were incorporated using a novel integrative technique to determine sleep and awake periods. Characteristics of acid reflux were compared between the recumbent-awake and recumbent-asleep periods.


RESULTS
Seventeen (44.7%) subjects had acid reflux events during recumbent-awake period as compared to seven (18.4%) in the corresponding recumbent-asleep period (P = 0.046). The mean number of acid reflux events in recumbent-awake period was significantly higher than in the corresponding recumbent-asleep period (8.1 +/- 4.4 vs. 3.2 +/- 1.5, P < 0.001). In the recumbent-awake period, 38.4% of acid reflux events were associated with GERD-related symptoms as compared with 3.7% of acid reflux events during the corresponding recumbent-asleep period (P = 0.01).


CONCLUSIONS
Increased acid reflux in the early recumbent period occurs primarily during the recumbent-awake and not during the recumbent-asleep period.
Allen
L
L
The Neuroenteric Clinical Research Group, Southern Arizona VA Health Care System, Tucson, AZ 85723-0001, USA.
Poh
C H
CH
Gasiorowska
A
A
Malagon
I
I
Navarro-Rodriguez
T
T
Cui
H
H
Powers
J
J
Moty
B
B
Willis
M R
MR
Ashpole
N
N
Quan
S F
SF
Fass
R
R
D056044:Actigraphy / Q000379:methods*; D002940:Circadian Rhythm; D050782:Esophageal pH Monitoring; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012890:Sleep; D011795:Surveys and Questionnaires