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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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Title: Efficacy of Proton Pump Inhibitor Therapy for Nocturnal GERD Symptoms and Associated Sleep Disturbances: A Systematic Review of Randomized Controlled Trials.
Authors: 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.
Source: Journal of clinical gastroenterology [J Clin Gastroenterol] 2026 Oct 01; Vol. 60 (9), pp. 767-776. Date of Electronic Publication: 2026 Oct 01.
Publication Type: Systematic Review; Journal Article
Language: English
Journal Info: 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.
MeSH Terms: 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
Abstract: 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.)
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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
Database: MEDLINE
Description
ISSN:1539-2031
DOI:10.1097/MCG.0000000000002428