The effect of acid suppression on sleep and cardiac autonomic regulation in GERD

Background/Aims: Autonomic dysfunction and sleep disturbances have been observed in patients with reflux disease. The study aim was to investigate whether acid suppression changed autonomic function and subjective sleep function in patients with erosive esophagitis. Methodology: Twenty-eight patients with erosive esophagitis underwent assessment of heart rate variability and a subjective sleep questionnaire. All patients were studied before and after esomeprazole or placebo. Results: Esomeprazole resulted in a significant improvement in the reflux symptoms in week 8 (P<0.001). The global Pittsburgh Sleep Quality Index score decreased from 6.0 at baseline to 3.6 in week 8 in patients treated with esomeprazole (P<0.01). There was no significant change in any variable of heart rate variability in week 8 in either the esomeprazole or the placebo group. Conclusions: In 8 weeks, acid suppression therapy leads to an improvement in sleep disturbances but does not affect autonomic function. The study confirms the utility of acid suppression therapy for the resolution of not only reflux symptoms but also sleep dysfunction.