Academic Journal

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

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Efficacy of Proton Pump Inhibitor Therapy for Nocturnal GERD Symptoms and Associated Sleep Disturbances: A Systematic Review of Randomized Controlled Trials.
Συγγραφείς: Koo TH; Gastrointestinal Function and Motility Unit, Hospital Pakar Universiti Sains Malaysia, School of Medical Sciences, Kota Bharu, Kelantan, Malaysia.; Division of Gastroenterology and Hepatology, The Esophageal and Swallowing Center, MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH., Shibli F; Institute of Gastroenterology and Liver Diseases, Emek Medical Center, Afula.; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa., Mari A; Department of Gastroenterology, Nazareth EMMS Hospital, Nazareth.; Faculty of Medicine in Galilee, Bar-Ilan University, Ramat Gan, Israel., Bar N; Department of Gastroenterology and Hepatology, Sourasky Medical Center, School of Medicine, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv., Fass R; Gastrointestinal Function and Motility Unit, Hospital Pakar Universiti Sains Malaysia, School of Medical Sciences, Kota Bharu, Kelantan, Malaysia.
Πηγή: Journal of clinical gastroenterology [J Clin Gastroenterol] 2026 Oct 01; Vol. 60 (9), pp. 767-776. Date of Electronic Publication: 2026 Oct 01.
Τύπος έκδοσης: Systematic Review; Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 7910017 Publication Model: Electronic Cited Medium: Internet ISSN: 1539-2031 (Electronic) Linking ISSN: 01920790 NLM ISO Abbreviation: J Clin Gastroenterol Subsets: MEDLINE
Imprint Name(s): Publication: <2015- > : Philadelphia, PA : Wolters Kluwer Health, Inc.
Original Publication: New York, Masson.
Ιατρικοί όροι (MeSH): Proton Pump Inhibitors*/therapeutic use , Proton Pump Inhibitors*/adverse effects , Proton Pump Inhibitors*/administration & dosage , Gastroesophageal Reflux*/drug therapy , Gastroesophageal Reflux*/complications , Sleep Wake Disorders*/drug therapy , Sleep Wake Disorders*/etiology, Heartburn/drug therapy ; Heartburn/etiology ; Humans ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Sleep Quality
Περίληψη: Goals: A systematic review was conducted to evaluate the efficacy and safety of proton pump inhibitor (PPI) therapy in relieving nocturnal reflux symptoms and sleep disturbances.
Background: Nocturnal gastroesophageal reflux disease (GERD) is commonly associated with sleep disturbances. The benefits of PPI therapy for GERD-related nocturnal reflux and sleep disturbance remain unclear.
Study: We searched the MEDLINE, EMBASE, and Cochrane CENTRAL databases from inception to March 1, 2026, for randomized controlled trials (RCTs) in adults with GERD and sleep disturbances that compared any PPI to placebo or an alternative therapy. The primary outcome was the proportion of patients experiencing 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 (TEAEs).
Results: Five RCTs involving 1495 patients met the inclusion criteria. Three placebo-controlled trials consistently showed that PPI therapy improved nighttime heartburn relief and GERD-related sleep disturbances compared with placebo. Subjective sleep quality and sleep-related daytime functioning also generally improved with PPI therapy. However, the findings were more heterogeneous across trials because of differences in study populations, comparators, and outcome measures. Across the placebo-controlled studies, TEAEs were generally similar between the PPI and placebo groups.
Conclusions: PPI therapy was associated with improvement in nighttime heartburn and reflux-related sleep disturbances, especially in patients with reflux-driven nocturnal symptoms. The available evidence also suggests potential improvement in subjective sleep quality and sleep-related daytime functioning.
(Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.)
References: Vakil N, Van Zanten SV, Kahrilas P, et al; Group GC. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am Coll Gastroenterol. 2006;101:1900–1920.
Yamasaki T, Hemond C, Eisa M, et al. The changing epidemiology of gastroesophageal reflux disease: are patients getting younger? J Neurogastroenterol Motil. 2018;24:559.
Zhang D, Liu S, Li Z, et al. Global, regional and national burden of gastroesophageal reflux disease, 1990–2019: update from the GBD 2019 study. Ann Med. 2022;54:1372–1384.
Jung H-k, Talley NJ. Gastroesophageal reflux disease and sleep disorders: evidence for a causal link and therapeutic implications. J Neurogastroenterol Motil. 2010;16:22.
Fass R, Achem SR. Noncardiac chest pain: epidemiology, natural course, and pathogenesis. J Neurogastroenterol Motil. 2011;17:110.
Mody R, Bolge SC, Kannan H, et al. Effects of gastroesophageal reflux disease on sleep and outcomes. Clin Gastroenterol Hepatol. 2009;7:953–959.
Shaker R, Castell DO, Schoenfeld PS, et al. Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association. Am Coll Gastroenterol. 2003;98:1487–1493.
Tan X, Wang S, Wu F, et al. Bidirectional correlation between gastroesophageal reflux disease and sleep problems: a systematic review and meta-analysis. PeerJ. 2024;12:e17202.
Yamasaki T, Quan SF, Fass R. The effect of sleep deficiency on esophageal acid exposure of healthy controls and patients with gastroesophageal reflux disease. Neurogastroenterol Motility. 2019;31:e13705.
Fujiwara Y, Arakawa T, Fass R. Gastroesophageal reflux disease and sleep disturbances. J Gastroenterol. 2012;47:760–769.
Shibli F, Skeans J, Yamasaki T, et al. Nocturnal gastroesophageal reflux disease (GERD) and sleep: an important relationship that is commonly overlooked. J Clin Gastroenterol. 2020;54:663–674.
Schuitenmaker JM, Kuipers T, Smout AJ, et al. Systematic review: clinical effectiveness of interventions for the treatment of nocturnal gastroesophageal reflux. Neurogastroenterol Motility. 2022;34:e14385.
Durazzo M, Lupi G, Cicerchia F, et al. Extra-esophageal presentation of gastroesophageal reflux disease: 2020 update. J Clin Med. 2020;9:2559.
Saber H, Ghanei M. Extra-esophageal manifestations of gastroesophageal reflux disease: controversies between epidemiology and clinic. Open Respir Med J. 2012;6:121.
Sandhu DS, Fass R. Current trends in the management of gastroesophageal reflux disease. Gut Liver. 2017;12:7.
Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am Coll Gastroenterol. 2022;117:27–56.
Strand DS, Kim D, Peura DA. 25 years of proton pump inhibitors: a comprehensive review. Gut Liver. 2016;11:27.
Kinoshita Y, Ishimura N, Ishihara S. Advantages and disadvantages of long-term proton pump inhibitor use. J Neurogastroenterol Motil. 2018;24:182.
Jeon HK, Kim GH. Can nocturnal acid-breakthrough be reduced by long-acting proton pump inhibitors? J Neurogastroenterol Motil. 2017;23:145.
Karyampudi A, Ghoshal UC, Singh R, et al. Esophageal acidification during nocturnal acid-breakthrough with ilaprazole versus omeprazole in gastroesophageal reflux disease. J Neurogastroenterol Motil. 2017;23:208.
Yadlapati R, DeLay KPPI. refractory gastroesophageal reflux disease. Med Clin North Am. 2018;103:15.
Aimi M, Komazawa Y, Hamamoto N, et al. Effects of omeprazole on sleep disturbance: randomized multicenter double-blind placebo-controlled trial. Clin Transl Gastroenterol. 2014;5:e57.
Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019;2019:ED000142.
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Brit Med J. 2021;372:n71.
Brown EG, Wood L, Wood S. The medical dictionary for regulatory activities (MedDRA). Drug Saf. 1999;20:109–117.
Higgins JP, Savović J, Page MJ, et al. Assessing risk of bias in a randomized trial. Cochrane Handbook Syst Rev Intervent. 2019;N/A:205–228.
Fass R, Johnson DA, Orr WC, et al. The effect of dexlansoprazole MR on nocturnal heartburn and GERD-related sleep disturbances in patients with symptomatic GERD. Am Coll Gastroenterol. 2011;106:421–431.
Johnson D, Crawley J, Hwang C, et al. Clinical trial: esomeprazole for moderate-to-severe nighttime heartburn and gastro-oesophageal reflux disease-related sleep disturbances. Aliment Pharmacol Ther. 2010;32:182–190.
Johnson DA, Orr WC, Crawley JA, et al. Effect of esomeprazole on nighttime heartburn and sleep quality in patients with GERD: a randomized, placebo-controlled trial. Am Coll Gastroenterol. 2005;100:1914–1922.
Mizuki A, Tatemichi M, Sakakibara T, et al. A multicenter, randomized, open-label trial: efficacy of once-daily versus twice-daily double-dose rabeprazole on refractory gastroesophageal reflux disease-related symptoms and quality of life. Curr Therap Res. 2016;79:1–7.
Orr W, Goodrich S, Robert J. The effect of acid suppression on sleep patterns and sleep-related gastro-oesophageal reflux. Aliment Pharmacol Therap. 2005;21:103–108.
Orr WC, Craddock A, Goodrich S. Acidic and non-acidic reflux during sleep under conditions of powerful acid suppression. Chest. 2007;131:460–465.
Yi C-H, Chen C-L, Kuo T, et al. The effect of acid suppression on sleep and cardiac autonomic regulation in GERD. Hepatogastroenterology. 2008;55(86-87):1649–1652.
Yadlapati R, Gyawali CP, Pandolfino JE, et al. AGA clinical practice update on the personalized approach to the evaluation and management of GERD: expert review. Clin Gastroenterol Hepatol. 2022;20:984–994.
Suurna MV, Welge J, Surdulescu V, et al. Randomized placebo-controlled trial of pantoprazole for daytime sleepiness in GERD and obstructive sleep disordered breathing. Otolaryngology—Head Neck Surg. 2008;139:286–290.
Bortolotti M, Gentilini L, Morselli C, et al. Obstructive sleep apnoea is improved by a prolonged treatment of gastrooesophageal reflux with omeprazole. Dig Liver Dis. 2006;38:78–81.
Rassameehiran S, Klomjit S, Hosiriluck N, et al. Meta-analysis of the effect of proton pump inhibitors on obstructive sleep apnea symptoms and indices in patients with gastroesophageal reflux disease. Taylor Francis. 2016;29:3–6.
Johnson DA, Le Moigne A, Li J, et al. Analysis of clinical predictors of resolution of sleep disturbance related to frequent nighttime heartburn and acid regurgitation symptoms in individuals taking esomeprazole 20 mg or placebo. Clin Drug Investig. 2016;36:531–538.
Contributed Indexing: Keywords: erosive esophagitis; gastroesophageal reflux disease; nonerosive reflux disease; proton pump inhibitor; sleep
Substance Nomenclature: 0 (Proton Pump Inhibitors)
Entry Date(s): Date Created: 20260724 Date Completed: 20260904 Latest Revision: 20260907
Update Code: 20260907
DOI: 10.1097/MCG.0000000000002428
PMID: 42496003
Βάση Δεδομένων: MEDLINE
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  Data: Efficacy of Proton Pump Inhibitor Therapy for Nocturnal GERD Symptoms and Associated Sleep Disturbances: A Systematic Review of Randomized Controlled Trials.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Koo+TH%22&quot;&gt;Koo TH&lt;/searchLink&gt;; Gastrointestinal Function and Motility Unit, Hospital Pakar Universiti Sains Malaysia, School of Medical Sciences, Kota Bharu, Kelantan, Malaysia.; Division of Gastroenterology and Hepatology, The Esophageal and Swallowing Center, MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Shibli+F%22&quot;&gt;Shibli F&lt;/searchLink&gt;; Institute of Gastroenterology and Liver Diseases, Emek Medical Center, Afula.; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Mari+A%22&quot;&gt;Mari A&lt;/searchLink&gt;; Department of Gastroenterology, Nazareth EMMS Hospital, Nazareth.; Faculty of Medicine in Galilee, Bar-Ilan University, Ramat Gan, Israel.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Bar+N%22&quot;&gt;Bar N&lt;/searchLink&gt;; Department of Gastroenterology and Hepatology, Sourasky Medical Center, School of Medicine, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Fass+R%22&quot;&gt;Fass R&lt;/searchLink&gt;; Gastrointestinal Function and Motility Unit, Hospital Pakar Universiti Sains Malaysia, School of Medical Sciences, Kota Bharu, Kelantan, Malaysia.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%227910017%22&quot;&gt;Journal of clinical gastroenterology&lt;/searchLink&gt; [J Clin Gastroenterol] 2026 Oct 01; Vol. 60 (9), pp. 767-776. &lt;i&gt;Date of Electronic Publication: &lt;/i&gt;2026 Oct 01.
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– Name: Abstract
  Label: Abstract
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  Data: Goals: A systematic review was conducted to evaluate the efficacy and safety of proton pump inhibitor (PPI) therapy in relieving nocturnal reflux symptoms and sleep disturbances.&lt;br /&gt;Background: Nocturnal gastroesophageal reflux disease (GERD) is commonly associated with sleep disturbances. The benefits of PPI therapy for GERD-related nocturnal reflux and sleep disturbance remain unclear.&lt;br /&gt;Study: We searched the MEDLINE, EMBASE, and Cochrane CENTRAL databases from inception to March 1, 2026, for randomized controlled trials (RCTs) in adults with GERD and sleep disturbances that compared any PPI to placebo or an alternative therapy. The primary outcome was the proportion of patients experiencing 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 (TEAEs).&lt;br /&gt;Results: Five RCTs involving 1495 patients met the inclusion criteria. Three placebo-controlled trials consistently showed that PPI therapy improved nighttime heartburn relief and GERD-related sleep disturbances compared with placebo. Subjective sleep quality and sleep-related daytime functioning also generally improved with PPI therapy. However, the findings were more heterogeneous across trials because of differences in study populations, comparators, and outcome measures. Across the placebo-controlled studies, TEAEs were generally similar between the PPI and placebo groups.&lt;br /&gt;Conclusions: PPI therapy was associated with improvement in nighttime heartburn and reflux-related sleep disturbances, especially in patients with reflux-driven nocturnal symptoms. The available evidence also suggests potential improvement in subjective sleep quality and sleep-related daytime functioning.&lt;br /&gt; (Copyright &#169; 2026 Wolters Kluwer Health, LLC. All rights reserved.)
– Name: Ref
  Label: References
  Group: RefInfo
  Data: Vakil N, Van Zanten SV, Kahrilas P, et al; Group GC. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am Coll Gastroenterol. 2006;101:1900–1920.&lt;br /&gt;Yamasaki T, Hemond C, Eisa M, et al. The changing epidemiology of gastroesophageal reflux disease: are patients getting younger? J Neurogastroenterol Motil. 2018;24:559.&lt;br /&gt;Zhang D, Liu S, Li Z, et al. Global, regional and national burden of gastroesophageal reflux disease, 1990–2019: update from the GBD 2019 study. Ann Med. 2022;54:1372–1384.&lt;br /&gt;Jung H-k, Talley NJ. Gastroesophageal reflux disease and sleep disorders: evidence for a causal link and therapeutic implications. J Neurogastroenterol Motil. 2010;16:22.&lt;br /&gt;Fass R, Achem SR. Noncardiac chest pain: epidemiology, natural course, and pathogenesis. J Neurogastroenterol Motil. 2011;17:110.&lt;br /&gt;Mody R, Bolge SC, Kannan H, et al. Effects of gastroesophageal reflux disease on sleep and outcomes. Clin Gastroenterol Hepatol. 2009;7:953–959.&lt;br /&gt;Shaker R, Castell DO, Schoenfeld PS, et al. Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association. Am Coll Gastroenterol. 2003;98:1487–1493.&lt;br /&gt;Tan X, Wang S, Wu F, et al. Bidirectional correlation between gastroesophageal reflux disease and sleep problems: a systematic review and meta-analysis. PeerJ. 2024;12:e17202.&lt;br /&gt;Yamasaki T, Quan SF, Fass R. The effect of sleep deficiency on esophageal acid exposure of healthy controls and patients with gastroesophageal reflux disease. Neurogastroenterol Motility. 2019;31:e13705.&lt;br /&gt;Fujiwara Y, Arakawa T, Fass R. Gastroesophageal reflux disease and sleep disturbances. J Gastroenterol. 2012;47:760–769.&lt;br /&gt;Shibli F, Skeans J, Yamasaki T, et al. Nocturnal gastroesophageal reflux disease (GERD) and sleep: an important relationship that is commonly overlooked. J Clin Gastroenterol. 2020;54:663–674.&lt;br /&gt;Schuitenmaker JM, Kuipers T, Smout AJ, et al. Systematic review: clinical effectiveness of interventions for the treatment of nocturnal gastroesophageal reflux. Neurogastroenterol Motility. 2022;34:e14385.&lt;br /&gt;Durazzo M, Lupi G, Cicerchia F, et al. Extra-esophageal presentation of gastroesophageal reflux disease: 2020 update. J Clin Med. 2020;9:2559.&lt;br /&gt;Saber H, Ghanei M. Extra-esophageal manifestations of gastroesophageal reflux disease: controversies between epidemiology and clinic. Open Respir Med J. 2012;6:121.&lt;br /&gt;Sandhu DS, Fass R. Current trends in the management of gastroesophageal reflux disease. Gut Liver. 2017;12:7.&lt;br /&gt;Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am Coll Gastroenterol. 2022;117:27–56.&lt;br /&gt;Strand DS, Kim D, Peura DA. 25 years of proton pump inhibitors: a comprehensive review. Gut Liver. 2016;11:27.&lt;br /&gt;Kinoshita Y, Ishimura N, Ishihara S. Advantages and disadvantages of long-term proton pump inhibitor use. J Neurogastroenterol Motil. 2018;24:182.&lt;br /&gt;Jeon HK, Kim GH. Can nocturnal acid-breakthrough be reduced by long-acting proton pump inhibitors? J Neurogastroenterol Motil. 2017;23:145.&lt;br /&gt;Karyampudi A, Ghoshal UC, Singh R, et al. Esophageal acidification during nocturnal acid-breakthrough with ilaprazole versus omeprazole in gastroesophageal reflux disease. J Neurogastroenterol Motil. 2017;23:208.&lt;br /&gt;Yadlapati R, DeLay KPPI. refractory gastroesophageal reflux disease. Med Clin North Am. 2018;103:15.&lt;br /&gt;Aimi M, Komazawa Y, Hamamoto N, et al. Effects of omeprazole on sleep disturbance: randomized multicenter double-blind placebo-controlled trial. Clin Transl Gastroenterol. 2014;5:e57.&lt;br /&gt;Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019;2019:ED000142.&lt;br /&gt;Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Brit Med J. 2021;372:n71.&lt;br /&gt;Brown EG, Wood L, Wood S. The medical dictionary for regulatory activities (MedDRA). Drug Saf. 1999;20:109–117.&lt;br /&gt;Higgins JP, Savović J, Page MJ, et al. Assessing risk of bias in a randomized trial. Cochrane Handbook Syst Rev Intervent. 2019;N/A:205–228.&lt;br /&gt;Fass R, Johnson DA, Orr WC, et al. The effect of dexlansoprazole MR on nocturnal heartburn and GERD-related sleep disturbances in patients with symptomatic GERD. Am Coll Gastroenterol. 2011;106:421–431.&lt;br /&gt;Johnson D, Crawley J, Hwang C, et al. Clinical trial: esomeprazole for moderate-to-severe nighttime heartburn and gastro-oesophageal reflux disease-related sleep disturbances. Aliment Pharmacol Ther. 2010;32:182–190.&lt;br /&gt;Johnson DA, Orr WC, Crawley JA, et al. Effect of esomeprazole on nighttime heartburn and sleep quality in patients with GERD: a randomized, placebo-controlled trial. Am Coll Gastroenterol. 2005;100:1914–1922.&lt;br /&gt;Mizuki A, Tatemichi M, Sakakibara T, et al. A multicenter, randomized, open-label trial: efficacy of once-daily versus twice-daily double-dose rabeprazole on refractory gastroesophageal reflux disease-related symptoms and quality of life. Curr Therap Res. 2016;79:1–7.&lt;br /&gt;Orr W, Goodrich S, Robert J. The effect of acid suppression on sleep patterns and sleep-related gastro-oesophageal reflux. Aliment Pharmacol Therap. 2005;21:103–108.&lt;br /&gt;Orr WC, Craddock A, Goodrich S. Acidic and non-acidic reflux during sleep under conditions of powerful acid suppression. 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  Data: &lt;i&gt;Keywords: &lt;/i&gt;erosive esophagitis; gastroesophageal reflux disease; nonerosive reflux disease; proton pump inhibitor; sleep
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260724 &lt;i&gt;Date Completed: &lt;/i&gt;20260904 &lt;i&gt;Latest Revision: &lt;/i&gt;20260907
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  Data: 10.1097/MCG.0000000000002428
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        Value: 10.1097/MCG.0000000000002428
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      – Code: eng
        Text: English
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        StartPage: 767
    Subjects:
      – SubjectFull: Heartburn drug therapy
        Type: general
      – SubjectFull: Heartburn etiology
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Randomized Controlled Trials as Topic
        Type: general
      – SubjectFull: Treatment Outcome
        Type: general
      – SubjectFull: Sleep Quality
        Type: general
      – SubjectFull: Proton Pump Inhibitors therapeutic use
        Type: general
      – SubjectFull: Proton Pump Inhibitors adverse effects
        Type: general
      – SubjectFull: Proton Pump Inhibitors administration & dosage
        Type: general
      – SubjectFull: Gastroesophageal Reflux drug therapy
        Type: general
      – SubjectFull: Gastroesophageal Reflux complications
        Type: general
      – SubjectFull: Sleep Wake Disorders drug therapy
        Type: general
      – SubjectFull: Sleep Wake Disorders etiology
        Type: general
    Titles:
      – TitleFull: Efficacy of Proton Pump Inhibitor Therapy for Nocturnal GERD Symptoms and Associated Sleep Disturbances: A Systematic Review of Randomized Controlled Trials.
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              M: 10
              Text: 2026 Oct 01
              Type: published
              Y: 2026
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