GERD Is Associated with Daytime Somnolence

Epidemiologic studies have suggested a relationshipbetween gastroesophageal reflux disease(GERD) and daytime somnolence, perhaps due tonighttime sleep disturbances and frequent awakeningscaused by nocturnal heartburn and regurgitationof gastric contents. The influence of GERDon daytime cognitive function was examined byP?l Demeter, MD, and colleagues in a study of 134patients undergoing upper panendoscopy. TheEpworth Sleepiness Scale (ESS) was used toevaluate sleepiness, and results were analyzedwith respect to the severity of endoscopic findings.

The results, which were reported in the June 2004issue of the World Journal of Gastroenterology,showed a positive relationship between reflux diseaseseverity and ESS scores. More severeGERD groups, categorized by the Savary-Millerclassification, exhibited a gradually increasing andmore "somnolent" result on the ESS. Mild somnolence(8 on the ESS) occurred in only 29% of theGERD 0 group (mild GERD) but was noted in 39%of the GERD I group and in 46% of the GERD IIgroup. Significant somnolence occurred in morethan 77% of patients in the GERD III group. Theauthors concluded that GERD severity affects daytimesomnolence and suggested that patients withextraesophageal symptoms may develop daytimesomnolence even earlier (and without visibleesophagitis) than those without extraesophagealsymptoms.