Esophageal reflux disease proton pump inhibitor therapy impact on sleep disturbance: a systematic review.
OBJECTIVE
To perform a systematic literature review that evaluates the impact of proton pump inhibitor treatment of gastroesophageal reflux disease on sleep disturbance-related outcomes.


METHODS
PubMed, Web of Science, and Cochrane databases were searched from 1989 (when omeprazole became available) to present; additional references gleaned from citations.


METHODS
The search strategy identified all randomized placebo-controlled clinical trials published in English; both proton pump inhibitor use and outcome measures of sleep disturbance were reported for esophageal reflux disease patients. Using a preestablished systematic review protocol and data extraction format, 4 coauthors independently reviewed all articles.


RESULTS
The original search identified 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 years; mean body mass index was 29.4 ± 2.9; the proportion of women varied widely across studies. Esomeprazole was studied most frequently. More than 50% of publications permitted rescue antacids. Two studies reported polysomnography outcomes, without statistically significant improvement. All studies reported non-polysomnography outcomes; 7 identified statistically significant improvements demonstrating drug treatment superiority over placebo.


CONCLUSIONS
The existing evidence supports the use of proton pump inhibitors as a treatment for esophageal reflux disease to improve quality-of-life sleep disturbance-related outcomes. Given the wide variability in proton pump inhibitor treatments and sleep disturbance-related outcomes reported, however, study-specific results cannot be directly compared or aggregated. This conclusion appears robust not only for 7 of 8 studies included but also for the 3 highest quality studies.
Division of Otolaryngology Head and Neck Surgery, Stony Brook University Medical Center, Stony Brook, New York 11794-8191, USA. elliot.regenbogen@sbumed.org
Elliot
E
Regenbogen
Alex
A
Helkin
Rachel
R
Georgopoulos
Tajender
T
Vasu
A Laurie W
AL
Shroyer
D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D017286:Polysomnography; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012893:Sleep Wake Disorders / Q000150:complications / Q000517:prevention & control*
D054328:Proton Pump Inhibitors