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Nighttime Acid Reflux a Problem for Many Americans

Posted on: Monday, 9 May 2005, 15:00 CDT

With a splash of stomach acid that singes the esophagus, heartburn awakens many American adults two or more times a month.

A new survey, drawing from the responses of nearly 4,000 people who suffer from heartburn, or acid reflux, during the night, gives new insight into the condition's triggers.

The findings suggest that people who want to avoid the discomfort and long-term medical consequences from heartburn should avoid carbonated drinks right before bedtime and skip certain types of sleeping pills.

"This is the first study to evaluate how common heartburn during sleep is in the general population of the United States," said Dr. Ronnie Fass of the Southern Arizona VA Health Care System and an associate professor at the University of Arizona School of Medicine. He is lead author of the study, published Tuesday in the journal Chest.

"We found that up to a quarter of the U.S. population loses sleep because of nighttime heartburn, and many of these individuals have related sleep complaints and suffer from excessive daytime sleepiness."

Researchers in Tucson, Ariz., Boston, Baltimore and Minneapolis distributed self-report sleep-habit surveys to more than 15,000 people at nine medical centers around the country. In addition to asking whether they were awakened by heartburn two or more times a month, the patients answered questions about their lifestyles, eating habits, medical histories and education.

A total of 3,806 patients responding to the survey reported nighttime heartburn, with researchers identifying as significant factors the consumption of carbonated beverages in the evening or taking one of a class of prescription sedatives called benzodiazepines (such as Halcion and Valium).

Other significant predictors for developing reflux was being overweight, suffering from various sleep abnormalities, hypertension and asthma.

The study also showed that college graduates were less likely to report having heartburn during sleep than those without a college education. Fass said this might simply reflect more sophistication in answering the survey, or indicate that people with better education have better health care, diet and lifestyle that helps them to better avoid the problem.

Fass said nighttime heartburn is a concern for more than lost sleep.

"It can be indicative of nighttime reflux, which has been shown to be associated with a more severe form of gastroesophageal reflux disease," Fass said.

This more serious condition of regular leakage of acid from the stomach is usually caused by the lower end of the esophagus not closing properly and can damage not only the food passageway, but also the throat and even the teeth.

"Inflammation of the esophagus, narrowing of the esophagus and even cancer of the esophagus have been associated with nighttime reflux," Fass said.

On the Net: www.chestnet.org

BREAKOUT MATERIAL

A nationwide survey of more than 15,000 people finds that nearly 1 in 4 experiences heartburn bad enough to wake them up at night at least twice a month. The study identifies drinking carbonated beverages and taking a certain class of prescription sleeping pill (the tranquilizer benzodiazepines) as some of the biggest triggers for heartburn, along with being overweight.

"There are simple lifestyle changes people can make to help reduce their frequency of heartburn during sleep," said Dr. Paul Kvale, president of the American College of Chest Physicians, which published the study.

"Reducing consumption of carbonated soft drinks, replacing benzodiazepines with other types of sleeping pills, and losing weight can all help reduce nighttime heartburn."

(Contact Lee Bowman at BowmanL(at)SHNS.com. Distributed by Scripps Howard News Service, http://www.shns.com)

© 2004 Scripps Howard News Service.

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