TY - JOUR
T1 - Temporal relationship between night-time gastroesophageal reflux events and arousals from sleep
AU - Shepherd, Kelly
AU - Ockelford, James
AU - Ganasan, Vijeyadezmi
AU - Holloway, Richard
AU - Hillman, David
AU - Eastwood, Peter
PY - 2020/5
Y1 - 2020/5
N2 - INTRODUCTION: Night-time gastroesophageal reflux (nGER) symptoms are commonly associated with interrupted sleep. Most studies attempting to understand the relationship between sleep, arousal, and nGER events have been performed so using accelerometry; however, this technology is limited in its ability to precisely determine the temporal association between sleep and reflux events. We aimed to examine the temporal relationships between nGER events and arousal/awakening from sleep using high resolution, in-laboratory polysomnography (PSG). METHODS: Individuals between 18 and 70 years who had undergone a gastroscopy within 12 months underwent simultaneous 24-hour pH/impedance monitoring and in-laboratory PSG. The temporal relationship between each nGER event and sleep/arousals/awakenings was determined for each participant. Analyses were limited to the sleep period (between “lights out” and time of final waking). RESULTS: Analyses were conducted on the data from 25 individuals, 64% of whom had nGER episodes (5 6 5 events per person, range 1–18) and 64% of whom had obstructive sleep apnea (OSA, mean apnea–hypopnea index 20 6 11 events/hr, range 6–44). There were no differences in PSG-determined sleep duration, sleep efficiency, sleep architecture, arousals/awakenings, or sleep apnea severity between those with nGER and those without. Most nGER events (82%) occurred during a PSG epoch that had been classified as wake. Arousals/awakenings preceded almost all events (73/76), whereas fewer had an arousal/awakening after the event (15/76). DISCUSSION: As opposed to what is typically assumed, nGER does not seem to cause arousal from sleep, but rather arousal from sleep predisposes to nGER.
AB - INTRODUCTION: Night-time gastroesophageal reflux (nGER) symptoms are commonly associated with interrupted sleep. Most studies attempting to understand the relationship between sleep, arousal, and nGER events have been performed so using accelerometry; however, this technology is limited in its ability to precisely determine the temporal association between sleep and reflux events. We aimed to examine the temporal relationships between nGER events and arousal/awakening from sleep using high resolution, in-laboratory polysomnography (PSG). METHODS: Individuals between 18 and 70 years who had undergone a gastroscopy within 12 months underwent simultaneous 24-hour pH/impedance monitoring and in-laboratory PSG. The temporal relationship between each nGER event and sleep/arousals/awakenings was determined for each participant. Analyses were limited to the sleep period (between “lights out” and time of final waking). RESULTS: Analyses were conducted on the data from 25 individuals, 64% of whom had nGER episodes (5 6 5 events per person, range 1–18) and 64% of whom had obstructive sleep apnea (OSA, mean apnea–hypopnea index 20 6 11 events/hr, range 6–44). There were no differences in PSG-determined sleep duration, sleep efficiency, sleep architecture, arousals/awakenings, or sleep apnea severity between those with nGER and those without. Most nGER events (82%) occurred during a PSG epoch that had been classified as wake. Arousals/awakenings preceded almost all events (73/76), whereas fewer had an arousal/awakening after the event (15/76). DISCUSSION: As opposed to what is typically assumed, nGER does not seem to cause arousal from sleep, but rather arousal from sleep predisposes to nGER.
KW - gastroesophageal reflux
KW - sleep
KW - accelerometry
KW - Night-time
KW - nGER
KW - in-laboratory polysomnography
KW - PSG
UR - http://www.scopus.com/inward/record.url?scp=85087432233&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/10316178
UR - http://purl.org/au-research/grants/NHMRC/1136548
U2 - 10.14309/ajg.0000000000000627
DO - 10.14309/ajg.0000000000000627
M3 - Article
C2 - 32356952
AN - SCOPUS:85087432233
VL - 115
SP - 697
EP - 705
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 5
ER -