Sleep and Nocturnal Gastroesophageal Reflux: An Update

Chest. 2018 Oct;154(4):963-971. doi: 10.1016/j.chest.2018.05.030. Epub 2018 May 31.


Nocturnal gastroesophageal reflux has been associated with poor sleep quality. Normal physiological adaptations of the aerodigestive system to sleep prolong and intensify nocturnal reflux events. This occurrence leads to sleep disruption, as well as to esophageal, laryngeal, and laryngopharyngeal reflux. Controversy exists on whether OSA and nocturnal reflux are causally linked or merely associated because of shared risk factors. Advances in diagnostic technology have provided new insights into gastroesophageal reflux and the mechanisms of nocturnal reflux during sleep. This update reviews new data on causal links between sleep and gastroesophageal reflux disease.

Keywords: CPAP; OSA; gastroesophageal reflux disease; lower esophageal sphincter; nocturnal acid breakthrough; sleep; transient lower esophageal sphincter relaxation; upper esophageal sphincter.

Publication types

  • Review

MeSH terms

  • Esophageal Motility Disorders / physiopathology
  • Esophageal Sphincter, Lower / physiology
  • Esophageal Sphincter, Upper / physiology
  • Gastric Acid / physiology
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / physiopathology
  • Humans
  • Sleep Apnea, Obstructive / complications*
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / physiopathology