Proton pump inhibitor therapy improves nighttime heartburn relief and GERD-related sleep disturbances in adults with nocturnal GERD and sleep disturbances
A systematic review of 5 RCTs involving 1495 patients found that PPI therapy consistently improved nighttime heartburn relief and GERD-related sleep disturbances compared to placebo in three placebo-controlled trials. Subjective sleep quality and sleep-related daytime functioning also generally improved with PPI therapy, though findings were more heterogeneous across trials.
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Proton pump inhibitor therapy improves nighttime heartburn relief and GERD-related sleep disturbances in adults with nocturnal GERD and sleep disturbances The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Proton pump inhibitor therapy improves nighttime heartburn relief and GERD-related sleep disturbances in adults with nocturnal GERD and sleep disturbances
This conclusion is most relevant to: Adults with GERD and sleep disturbances.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Efficacy of Proton Pump Inhibitor Therapy for Nocturnal GERD Symptoms and Associated Sleep Disturbances: A Systematic Review of Randomized Controlled Trials. (Journal of clinical gastroenterology, 2026) — A systematic review of 5 RCTs involving 1495 patients found that PPI therapy consistently improved nighttime heartburn relief and GERD-related sleep disturbances compared to placebo in three placebo-controlled trials. Subjective sleep quality and sleep-related daytime functioning also generally improved with PPI therapy, though findings were more heterogeneous across trials.
How It Works
The proposed biological pathway:
- ▸PPI reduces gastric acid secretion
- ▸Decreased acid exposure in the esophagus during nighttime
- ▸Reduction in nocturnal reflux events and associated symptoms
- ▸Result: Improved nighttime heartburn relief and reduced sleep disturbances
Who Might Benefit
Evidence fit by population:
- ▸Adults with GERD and sleep disturbances
Recommended Dose
N/A (not specified in abstract)
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Only 5 RCTs met inclusion criteria, limiting generalizability
- ▸Heterogeneity across trials in study populations, comparators, and outcome measures
Frequently Asked Questions
Does PPI therapy improve sleep quality in patients with nocturnal GERD?▼
Yes, the systematic review found that PPI therapy generally improved subjective sleep quality and sleep-related daytime functioning, though results were more variable across studies.
How many patients were included in this systematic review?▼
The review included 5 randomized controlled trials with a total of 1495 patients.
What were the main outcomes measured in the included trials?▼
The primary outcome was relief from nighttime heartburn. Secondary outcomes included relief from GERD-related sleep disturbances, changes in subjective sleep quality, work productivity, and treatment-emergent adverse events.
Were there any safety concerns with PPI therapy for nocturnal GERD?▼
Treatment-emergent adverse events were generally similar between PPI and placebo groups across the placebo-controlled studies, suggesting a favorable safety profile.
References
- 1.Koo TH, Shibli F, Mari A, Bar N, Fass R. “Efficacy of Proton Pump Inhibitor Therapy for Nocturnal GERD Symptoms and Associated Sleep Disturbances: A Systematic Review of Randomized Controlled Trials..” Journal of clinical gastroenterology, 2026. PMID: 42496003 DOI: 10.1097/MCG.0000000000002428