Associations Between Sleep Position and Nocturnal Gastroesophageal Reflux: A Study Using Concurrent Monitoring of Sleep Position and Esophageal pH and Impedance.
Level 3 - non-randomized controlled study
Observational cohort study with within-subject positional comparisons during ambulatory monitoring
PubMed 34928874 · doi:10.14309/ajg.0000000000001588
What was done
Fifty-seven patients referred for ambulatory pH-impedance reflux monitoring had their spontaneous sleep positions (left, right, supine, and prone) measured concurrently using a sleep position measurement device.
What was found
Acid exposure time was significantly shorter in the left lateral position (median 0.0%, P25-P75 0.0%-3.0%) compared with the right lateral position (median 1.2%, 0.0%-7.5%, P = 0.022) and the supine position (median 0.6%, 0.00%-8.3%, P = 0.022). Esophageal acid clearance time was also significantly shorter in the left lateral decubitus position (median 35 seconds, 16-115 seconds) compared with the supine (median 76 seconds, 22-257 seconds, P = 0.030) and right lateral positions (median 90 seconds, 26-250 seconds, P = 0.002).
Why it matters
This study provides quantitative evidence that spontaneous left lateral sleeping reduces nocturnal esophageal acid exposure time and accelerates acid clearance compared to right lateral and supine sleeping.
Limits
The study is limited to a small sample size (n = 57) of patients referred for reflux monitoring, which may not generalize to asymptomatic populations. Sleep positions were spontaneous rather than randomized or controlled, and outcomes for the prone position were not reported in the abstract.
Cited by
- supports Sleeping on the right side causes gastric juices to leak and triggers gastroesophageal reflux disease, whereas sleeping on the left side avoids this.