Sleep positional therapy for the treatment of nocturnal gastroesophageal reflux

Gastroesophageal reflux disease (GERD) is one of the most common gastro-intestinal disorders with an estimated prevalence of 7%-33% worldwide and results in a major burden on the health care system given medical visits, costs of treatments and loss of work productivity (1). Treatment of GERD in general consists of lifestyle changes, acid-suppressive medication and sometimes surgery, depending on the severity of the disease. However, a large proportion of patients with reflux disease remain under treatment at the general practitioner or help themselves in which lifestyle advice and over the counter acid suppressive medication.
It has been shown that body position during sleeping has an effect on nocturnal gastroesophageal reflux. When sleeping in a left lateral decubitus position, the stomach is positioned below the esophagus, resulting in less reflux episodes. The efficacy of electronic sleep position training devices have already been proven in patients with sleep apnea and excessive snoring, in which patients are trained by means of vibration to turn from the back to the left or right side (2, 3). By adapting the vibration/position threshold of such a device, it is also possible to train patients to lie on their left side, thereby reducing nocturnal reflux. Positional therapy may thus provide a simple, cheap and effective in the treatment of GERD.

The main objective of the study is to assess the effect of sleep positional therapy, using the LEFT device, on nocturnal gastroesophageal reflux.

Baseline and after 2 weeks of treatment.

The LEFT is a wearable device worn on the upper chest and helps patients with nocturnal reflux complaints to sleep more on their left side. The LEFT will gently vibrate when the body is in the “wrong” sleep position (right side position).