Sleep Deprivation Is Hyperalgesic in Patients With Gastroesophageal Reflux Disease

Ron Schey, Ram Dickman, Sairam Parthasarathy, Stuart F Quan, Christopher S Wendel, Jonah Merchant, Jeannette Powers, Bing Han, Daniel van Handel, Ronnie Fass

Research output: Contribution to journalArticle

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Abstract

Background & Aims: Studies have demonstrated that gastroesophageal reflux disease (GERD) can cause sleep deprivation because of nighttime heartburn or short, amnestic arousals during sleep. Sleep deprivation has been associated with reports of increased GERD severity. Our aim was to determine whether sleep deprivation enhances perception of intraesophageal acid in patients with GERD vs healthy controls. Methods: Ten healthy controls and 10 patients with erosive esophagitis (grades B-D) were included in the study. All subjects were randomized to either sleep deprivation (1 night with ≤3 hours of sleep) or sufficient sleep (3 days with ≥7 hours sleep/night). Patients crossed over to the other arm after a washout period of 1 week. To ensure proper sleep time, we objectively monitored subjects with an actigraph. The morning after sufficient sleep or sleep deprivation, patients underwent stimulus response functions to esophageal acid perfusion. Results: Ten healthy controls and 10 GERD patients completed all stages of the study. GERD patients demonstrated a significant decrease in lag time to symptom report (91 ± 21.6 vs 282.7 ± 67 sec, respectively, P = .02), increase in intensity rating (9.3 ± 1.4 vs 4.4 ± 0.9 cm, respectively, P = .02), and increase in acid perfusion sensitivity score (48.3 ± 8.5 vs 22.7 ± 4.5 sec × cm/100, respectively, P = .02) after sleep deprivation as compared with nights of good sleep. Normal subjects did not demonstrate any differences in stimulus response functions to acid between sufficient sleep and sleep deprivation (578 ± 164 vs 493.8 ± 60.3 sec, 0.3 ± 0.2 vs 0.45 ± 0.2 cm, and 0.4 ± 0.3 vs 2.4 ± 1.4 sec × cm/100, respectively, all P = NS). Conclusions: Sleep deprivation is hyperalgesic in patients with GERD and provides a potential mechanism for increase in GERD symptom severity in sleep-deprived patients.

Original languageEnglish (US)
Pages (from-to)1787-1795
Number of pages9
JournalGastroenterology
Volume133
Issue number6
DOIs
StatePublished - Dec 2007

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Sleep Deprivation
Gastroesophageal Reflux
Sleep
Acids
Perfusion
Heartburn
Esophagitis
Arousal

ASJC Scopus subject areas

  • Gastroenterology

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Sleep Deprivation Is Hyperalgesic in Patients With Gastroesophageal Reflux Disease. / Schey, Ron; Dickman, Ram; Parthasarathy, Sairam; Quan, Stuart F; Wendel, Christopher S; Merchant, Jonah; Powers, Jeannette; Han, Bing; van Handel, Daniel; Fass, Ronnie.

In: Gastroenterology, Vol. 133, No. 6, 12.2007, p. 1787-1795.

Research output: Contribution to journalArticle

Schey, R, Dickman, R, Parthasarathy, S, Quan, SF, Wendel, CS, Merchant, J, Powers, J, Han, B, van Handel, D & Fass, R 2007, 'Sleep Deprivation Is Hyperalgesic in Patients With Gastroesophageal Reflux Disease', Gastroenterology, vol. 133, no. 6, pp. 1787-1795. https://doi.org/10.1053/j.gastro.2007.09.039
Schey, Ron ; Dickman, Ram ; Parthasarathy, Sairam ; Quan, Stuart F ; Wendel, Christopher S ; Merchant, Jonah ; Powers, Jeannette ; Han, Bing ; van Handel, Daniel ; Fass, Ronnie. / Sleep Deprivation Is Hyperalgesic in Patients With Gastroesophageal Reflux Disease. In: Gastroenterology. 2007 ; Vol. 133, No. 6. pp. 1787-1795.
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AU - Dickman, Ram

AU - Parthasarathy, Sairam

AU - Quan, Stuart F

AU - Wendel, Christopher S

AU - Merchant, Jonah

AU - Powers, Jeannette

AU - Han, Bing

AU - van Handel, Daniel

AU - Fass, Ronnie

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