Abstract
In a randomized crossover study, we compared the effect on gastroesophageal reflux of three sleeping positions: elevation of the head of the bed on standard eight-inch bed blocks; elevation by a foam wedge; or a flat position. Fifteen subjects with moderate to severe reflux symptoms were studied in each position on consecutive nights using continuous intraesophageal pH monitoring. We found no difference in reflux frequency among the positions. The wedge caused a statistically significant decrease in the time that distal esophageal pH was less than 4 as compared to the flat position. The wedge also decreased the longest episode experienced by the subjects. Elevation on blocks caused a similar improvement in parameters but failed in this study to achieve statistical significance. Both elevation by a wedge and on blocks showed a trend towards a decrease in clearance time as compared to the flat position. The patients did not always prefer elevation on a wedge, but for some it is a valuable alternative to elevation by bed blocks.
Similar content being viewed by others
References
Pope CE: Gastroesophageal reflux disease.In Gastrointestinal Disease: Pathophysiology, Diagnosis, Management. Philadelphia, WB Saunders, 1983, pp 449–490
Castell DO: Medical therapy of reflux esophagitis. Ann Intern Med 93:926–927, 1980
Richter JE, Castell DO: Gastroesophageal reflux: Pathogenesis, diagnosis, and therapy. Ann Intern Med 97:93–103, 1982
Bachman BA: Gastroesophageal reflux: simple measures often suffice. Postgrad Med 74:133–141, 1983
Johnson LF, DeMeester TR: Evaluation of elevation of the bed, bethanechol, and antacid foam tablets on gastroesophageal reflux. Dig Dis Sci 26:673–680, 1981
Falor WH, Chang B, White HA, Kraus JM, Taylor B, Hansel JR, Kraus FC: Twenty-four-hour esophageal pH monitoring by telemetry: Cost-effective use in out-patients. Am J Surg 142:514–516; 1981
Atkinson M, VanGelder A: Esophageal intraluminal pH recording in the assessment of gastroesophageal reflux and its consequences. Dig Dis Sci 22:365–370, 1977
Babka JC, Hager GW, Castell DO: The effect of body position on lower esophageal sphincter pressure. Dig Dis Sci 18:441–442, 1973
Helm JF, Dodds WJ, Riedel DR, Teeter BC, Hogan WJ, Arndorfer RC: Determinants of esophageal acid clearance in normal subjects. Gastroenterology 85:607–612, 1983
Dent J, Dodds WJ, Friedman RH, Sekiguchi T, Hogan WJ, Arndorfer RC, Petrie DJ: Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects. J Clin Invest 65:256–267, 1980
Orr CW, Johnson LF, Robinson MG: Effect of sleep on swallowing, esophageal peristalsis, and acid clearance. Gastroenterology 86:814–819, 1984
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hamilton, J.W., Boisen, R.J., Yamamoto, D.T. et al. Sleeping on a wedge diminishes exposure of the esophagus to refluxed acid. Digest Dis Sci 33, 518–522 (1988). https://doi.org/10.1007/BF01798350
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01798350