title: The effect of baclofen on nocturnal gastroesophageal reflux and measures of sleep quality: a randomized, cross-over trial.
abstract: BACKGROUND
  Baclofen, a GABA(b) agonist, has been shown to reduce episodes of gastroesophageal reflux (GER). To determine if baclofen would significantly reduce reflux during sleep, and also improve objective and subjective measures of sleep.
  
  
  METHODS
  Twenty-one individuals with complaints of nighttime heartburn at least twice a week and a Carlsson GERD score of at least 5 were studied. Patients underwent polysomnography (PSG) and simultaneous esophageal pH monitoring on two occasions separated by approximately 1 week in a cross-over design. The night of each polysomnographic study, patients consumed a refluxogenic meal. Baclofen (40 mg) or placebo was given in random order 90 min prior to the start of the PSG.
  
  
  RESULTS
  Baclofen significantly reduced the number of reflux events compared with placebo. Upright and recumbent acid contact times were both reduced by baclofen vs placebo, but the differences were not significant. Regarding sleep outcomes, several variables were significantly improved by baclofen. Total sleep time and sleep efficiency increased, and wake after sleep onset decreased in the baclofen condition compared with placebo. Proportion of Stage 1 sleep was also significantly decreased on baclofen.
  
  
  CONCLUSIONS
  In addition to reducing the number of reflux events during sleep, baclofen significantly improved several measures of sleep in patients with documented GER and sleep disturbances. Baclofen could therefore be considered as a useful adjunct therapy to proton pump inhibitors (PPIs) in patients with nighttime heartburn and sleep disturbance who continue to have heartburn and/or sleep complaints despite PPI therapy.
authors.affiliation: Lynn Institute for Healthcare Research, Oklahoma City, OK, USA. worr@lhsi.net
authors.forename: W C
authors.initials: WC
authors.lastname: Orr
authors.forename: S
authors.initials: S
authors.lastname: Goodrich
authors.forename: S
authors.initials: S
authors.lastname: Wright
authors.forename: K
authors.initials: K
authors.lastname: Shepherd
authors.forename: M
authors.initials: M
authors.lastname: Mellow
mesh_terms: D000328:Adult; D000368:Aged; D001418:Baclofen / Q000494:pharmacology / Q000627:therapeutic use*; D018592:Cross-Over Studies; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000494:pharmacology / Q000627:therapeutic use*; D017286:Polysomnography; D012890:Sleep / Q000187:drug effects*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen