SLEEP-RELATED GASTROESOPHAGEAL REFLUX - PROVOCATION WITH A LATE EVENING MEAL AND TREATMENT WITH ACID SUPPRESSION

Background: Two studies were carried out in order to investigate the i ssue of meal-provoked nocturnal gastrooesophageal reflux. Methods: In Experiment 1, 20 symptomatic reflux patients underwent both pH and pol ysomnographic monitoring on two nights. On one night, patients ate a n on-provocative meal prior to 19.00 hours, while on the other night pat ients consumed a late evening meal (21.00 hours). In Experiment 2, 17 symptomatic reflux patients were studied using pH and polysomnographic monitoring on two nights subsequent to a late evening provocative mea l. On one night, patients received 75 mg of the H-2-antagonist ranitid ine, while on another night they received a placebo, The data from 12 of the 17 patients studied were used in the analysis. Results: For Exp eriment 1, no significant differences in the number or duration of ref lux events, acid exposure (total %), or polysomnographic measures of p er cent of sleep stages between the two nights were observed. The resu lts of the second experiment demonstrated that when given ranitidine, patients experienced significant decrease in acid contact time (total %), and mean duration of reflux events. Subjective reports of discomfo rt and sleep disturbance were also significantly improved on the drug night. However, significant differences in polysomnographic measures w ere not observed. Conclusions: Based on these results, we conclude tha t in some symptomatic reflux patients a late-night nonprovocative meal may not increase the incidence of gastro-oesophageal reflux, and that a low dose of an H-2-antagonist is effective in decreasing oesophagea l acid contact time following a late evening provocative meal.