PPI therapy relieves nocturnal GERD symptoms, improves sleep quality

Use of proton pump inhibitors (PPIs) results in improvements in nighttime heartburn and reflux-related sleep disturbances, particularly in patients with reflux-driven nocturnal symptoms, a study has shown.

The authors identified randomized controlled trials (RCTs) in adults with gastroesophageal reflux disease (GERD) and sleep disturbances that compared any PPI to placebo or an alternative therapy using the databases of Medline, Embase, and Cochrane CENTRAL from inception to 1 March 2026.

The proportion of patients experiencing relief from nighttime heartburn served as the primary outcome. Other outcomes assessed included relief from GERD-related sleep disturbances, changes in subjective sleep quality, work productivity, and treatment-emergent adverse events (TEAEs).

Five RCTs, comprising 1,495 patients, were included in the analysis. In three placebo-controlled trials, PPI therapy consistently relieved nighttime heartburn and reduced GERD-related sleep disturbances compared with placebo.

Likewise, PPI use improved subjective sleep quality and sleep-related daytime functioning.

However, the findings were more heterogeneous across trials due to the differences in study populations, comparators, and outcome measures.

Moreover, TEAEs across placebo-controlled trials were generally similar between PPI and placebo.

“The available evidence also suggests potential improvement in subjective sleep quality and sleep-related daytime functioning,” the authors said.

“Nocturnal GERD is commonly associated with sleep disturbances,” they said. “The benefits of PPI therapy for GERD-related nocturnal reflux and sleep disturbance remain unclear.”