Nocturnal GERD and sleep disruption: Systematic review highlights PPI efficacy

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Created On: 21/09/2026

Nocturnal gastroesophageal reflux disease (GERD) is strongly linked to fragmented sleep, frequent nocturnal awakenings, and diminished daytime functioning.

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Key take away

Proton pump inhibitor (PPI) therapy reduces nighttime heartburn and gastroesophageal reflux disease (GERD)–related sleep disturbances without increasing treatment-emergent adverse events.

Background

Nocturnal gastroesophageal reflux disease (GERD) is strongly linked to fragmented sleep, frequent nocturnal awakenings, and diminished daytime functioning. Although proton pump inhibitors (PPIs) are the standard of care for daytime reflux, their efficacy and safety profile specifically targeting GERD-associated nocturnal symptoms and sleep quality parameters require synthesized evaluation.

Method

Investigators carried out a systematic review searching the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE. The search targeted randomized controlled trials (RCTs) evaluating adult populations with GERD and concurrent sleep disturbances receiving any PPI regimen vs. placebo or active comparators.

Primary outcome: Proportion of patients achieving relief from nighttime heartburn.
Secondary outcomes: Relief from GERD-related sleep disturbances, subjective sleep quality changes, work productivity metrics, and incidence of treatment-emergent adverse events (TEAEs).

Result

Five RCTs comprising a total of 1,495 volunteers fulfilled the inclusion criteria.

Symptom Control & Sleep: Three placebo-controlled trials demonstrated consistent superiority of PPI therapy over placebo in mitigating nighttime heartburn and resolving GERD-related sleep disturbances.
Quality of Life & Function: Those receiving PPIs generally demonstrated improvements in subjective sleep quality and sleep-related daytime functioning. However, findings varied across trials owing to heterogeneity in patient cohorts, therapeutic comparators, and outcome assessment instruments.
Safety: Incidence of TEAEs was comparable between PPI and placebo cohorts across all placebo-controlled trials.

Conclusion

PPI therapy effectively alleviated nighttime heartburn and GERD-associated sleep disruption, particularly in those with documented reflux-driven nocturnal symptoms, while maintaining a favorable safety profile.

Source:

Journal of Clinical Gastroenterology

Link:

https://www.ovid.com/jnls/jcge/abstract/10.1097/mcg.0000000000002428~efficacy-of-proton-pump-inhibitor-therapy-for-nocturnal-gerd?redirectionsource=fulltextview

Article:

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