title: A Novel Sleep Positioning Device Reduces Gastroesophageal Reflux: A Randomized Controlled Trial.
abstract: OBJECTIVE
  We hypothesized that sleeping left-side down with the head/torso elevated reduces recumbent gastroesophageal reflux (GER).
  
  
  BACKGROUND
  Previous studies show that sleeping with head of bed elevated or on wedge reduces GER and lying left-side down reduces GER versus right-side down and supine. No prior studies have evaluated the potential compounding effects of lying in an inclined position combined with lateral positioning on GER.
  
  
  METHODS
  We evaluated a sleep-positioning device (SPD) consisting of an inclined base and body pillow that maintains lateral position while elevating the head/torso. This was a single institution, randomized controlled trial involving 20 healthy volunteers receiving 4 six-hour impedance-pH tests. After placement of reflux probe, subjects returned home, ate standardized meal, and lay down in randomly assigned positions: SPD right-side down (SPD-R), SPD left-side down (SPD-L), standard wedge any position (W), or flat any position (F). A wireless accelerometer documented position during each study. Number of reflux episodes (RE) and esophageal acid exposure (EAE) were calculated over 6 hours.
  
  
  RESULTS
  Significantly less EAE occurred during sleeping SPD-L versus sleeping W, SPD-R, and F. The most EAE occurred during sleeping SPD-R despite use of the positioning device. RE were significantly less SPD-L than SPD-R. Patients sleeping SPD-L and SPD-R spent the majority of first 2 hours and greater than half of 6 hours in assigned position. Patients sleeping W and F averaged more time supine than right or left.
  
  
  CONCLUSIONS
  The sleep positioning device maintains recumbent position effectively. Lying left-side down, it reduces recumbent esophageal acid exposure.
authors.affiliation: *University of Maryland Gastroenterology, Baltimore, MD †Medical University of South Carolina Gastroenterology, Charleston, SC ‡Amenity Health Inc., San Diego, CA.
authors.forename: Erik
authors.initials: E
authors.lastname: Person
authors.forename: Christopher
authors.initials: C
authors.lastname: Rife
authors.forename: Janice
authors.initials: J
authors.lastname: Freeman
authors.forename: Aaron
authors.initials: A
authors.lastname: Clark
authors.forename: Donald O
authors.initials: DO
authors.lastname: Castell
mesh_terms: D000328:Adult; D017097:Electric Impedance; D004867:Equipment Design; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology*; D016683:Supine Position / Q000502:physiology*