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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

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.

Last updated: Jul 28, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Efficacy of Proton Pump Inhibitor Therapy for Nocturnal GERD Symptoms and Associated Sleep Disturbances: A Systematic Review of Randomized Controlled Trials.

rct

Koo TH, Shibli F, Mari A, Bar N, Fass R · Journal of clinical gastroenterology (2026)

Participants: 1495
Duration: N/A (not specified in abstract)
Intervention: Proton pump inhibitor (PPI) therapy (any PPI) compared to placebo or alternative therapy
Outcome: Relief from nighttime heartburn (primary), relief from GERD-related sleep disturbances, subjective sleep quality, work productivity, treatment-emergent adverse events
Effect Size: N/A (not reported in abstract)
Population: Adults with GERD and sleep disturbances

Result: 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.

PubMed: 42496003DOI: 10.1097/MCG.0000000000002428

Mechanism Graph

PPI reduces gastric acid secretion
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Decreased acid exposure in the esophagus during nighttime
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Reduction in nocturnal reflux events and associated symptoms
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Result: Improved nighttime heartburn relief and reduced sleep disturbances

Limitations

  • ⚠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.

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References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.