The impact of nocturnal symptoms associated with gastroesophageal reflux disease on health-related quality of life

Background: Two types of reflux episodes have been identified: upright or d aytime and supine or nocturnal. The population-based prevalence of symptoms of nocturnal gastroesophageal reflux disease (GERD) and the impact of thos e symptoms on health-related quality of life (HRQL) have not been establish ed. Methods: A national random-sample telephone survey was conducted to estimat e the prevalence of frequent GERD and nocturnal GERD-like symptoms and to a ssess the relationship between HRQL, GERD, and nocturnal GERD symptoms. Res pondents were classified as controls, subjects with symptomatic nonnocturna l GERD, and subjects with symptomatic nocturnal GERD. The HRQL was assessed using the Medical Outcomes Study Short-Form 36 Health Survey (SF-36). Results: The prevalence of frequent GERD was 14%, with an overall prevalenc e of nocturnal GERD of 10%. Seventy-four percent: of those with frequent GE RD symptoms reported nocturnal GERD symptoms. Subjects with nonnocturnal GE RD had significant decrements on the SF-36 physical and mental component su mmary scores compared with the US general population. Subjects reporting no cturnal GERD symptoms were significantly more impaired than subjects report ing nonnocturnal GERD symptoms on both the physical component summary (38.9 4 vs 41.52; P<.001) and mental component summary (46.78 vs 49.51; P<.001) a nd all 8 subscales of the SF-36 (P<.001). Subjects with nocturnal GERD demo nstrated considerable impair ment compared with the US general population a nd chronic disease populations. Subjects with nocturnal GERD had significan tly more pain than those with hypertension and diabetes (P<.001) and simila r pain compared with those with angina and congestive heart failure. Conclusions: Nocturnal symptoms are commonly experienced by individuals who report frequent GERD symptoms. In addition, HRQL is significantly impaired in those persons who report frequent GERD symptoms, and HRQL impairment is exacerbated in those who report nocturnal GERD symptoms.