Treatment of laryngopharyngeal reflux using a sleep positioning device: A prospective cohort study

Am J Otolaryngol. Sep-Oct 2017;38(5):603-607. doi: 10.1016/j.amjoto.2017.06.012. Epub 2017 Jun 27.

Abstract

Objective: Laryngopharyngeal reflux (LPR) symptoms are often resistant to management and cause significant quality of life impairment to patients with this disease. This study assesses the utility of a sleep-positioning device (SPD) in treating LPR.

Design: Single center prospective cohort study.

Setting: Tertiary medical center PARTICIPANTS: 27 adult patients with diagnosed laryngopharyngeal reflux.

Intervention: An SPD consisting of a two-component wedge-shaped base pillow and a lateral positioning body pillow (Medcline, Amenity Health Inc.) was given to patients with a diagnosis of LPR. Subjects slept using the device for at least 6h per night for 28 consecutive nights.

Main outcomes: Primary outcomes were Nocturnal Gastroesophageal Reflux Symptom Severity and Impact Questionnaire (N-GSSIQ) and the Reflux Symptoms Index (RSI) survey instrument. Each was collected at baseline, after 14, and after 28days of SPD use.

Results: 27 patients (19 female and 8 male; age 57.1±12.8, BMI 29.0±8.1) were recruited. At baseline mean N-GSSIQ was 50.1±22.4 and mean RSI of 29.6±7.7. Repeated measure analysis showed that subjects' total N-GSSIQ scores decreased by an average of 19.1 (p=0.0004) points by two weeks and 26.5 points by 4weeks (p<0.0001). RSI decreased an average of 5.3 points by 2weeks (p=0.0425) and an average of 14.0 points by 4weeks (p<0.0001).

Conclusions: In patients with LPR, SPD treatment significantly improves self-reported symptoms of nocturnal reflux as well as symptoms specific to LPR. These results support the therapeutic efficacy of a SPD for patients with LPR.

Keywords: Cohort study; Gerd; Hoarseness; Laryngopharyngeal reflux; Lpr; Medcline; Pillow; Pilot; Reflux; Sleep positioning device; Wedge.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Laryngopharyngeal Reflux / prevention & control*
  • Male
  • Middle Aged
  • Patient Positioning / instrumentation*
  • Posture*
  • Prospective Studies
  • Quality of Life
  • Sleep*
  • Surveys and Questionnaires
  • Treatment Outcome