ABSTRACT
Gastroesophageal dysfunction, as evidenced by the reflux of gastric contents into
the esophagus, has been implicated in a broad range of clinical symptoms (1).
Some of these clinical problems ascribed to reflux, such as sleep disrup-
tion, apparent life-threatening events (apnea and bradycardia), and nocturnal
asthma may occur primarily, or exclusively, during the night as a result of the
reflux episode. In addition, reflux during sleep, coupled with a sleep state-
related loss of normal airway and esophageal mucosal protective mechanisms
may contribute to the severity of the gastroesophageal reflux disease (GERD)–
related esophagitis, laryngeal irritation, and asthma. Finally, conditions asso-
ciated with increased work of breathing during sleep, such as obstructive sleep
apnea and nocturnal asthma, may also predispose to gastroesophageal reflux
(GER), which may then produce esophagitis and other complications such as
wheezing. These complications may, in turn, become more severe because they
occur during sleep (2,3).
