{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T02:48:36Z","timestamp":1770432516070,"version":"3.49.0"},"reference-count":21,"publisher":"BMJ","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1991,11]]},"abstract":"<jats:p>Nocturnal gastro-oesophageal reflux may be important in the pathogenesis of reflux oesophagitis. This study aimed to determine whether: (1) gastro-oesophageal reflux occurs during sleep in patients with reflux oesophagitis and, if so, to explore the mechanism, and (2) the sleep pattern of patients with oesophagitis is different from that of control subjects. After a standard evening meal, simultaneous manometric, oesophageal pH, and polysomnographic recordings were obtained in 11 patients with endoscopic oesophagitis and 11 control subjects. Patients with gastrooesophageal reflux disease had significantly more total reflux episodes throughout the nocturnal monitoring period than control subjects (105 v 6). Ninety two of 105 episodes of gastro-oesophageal reflux in patients occurred during the awake state and 10 during sleep stage II. A number of reflux episodes occurred during brief periods of arousal from the various sleep stages. Of the 105 reflux events recorded in patients, 42 were induced by transient lower oesophageal sphincter relaxation, 20 by stress reflux, 22 by free reflux mechanisms, and in 21 the mechanism was unclear. The sleep pattern and the time spent in each sleep stage was not different between the two groups. It is concluded that the awake state is crucial for the occurrence of nocturnal reflux episodes in normal subjects as well as in patients with reflux oesophagitis and that the difference between the frequency of gastro-oesophageal reflux between normal subjects and patients cannot be explained by different sleep patterns.<\/jats:p>","DOI":"10.1136\/gut.32.11.1275","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"1275-1279","source":"Crossref","is-referenced-by-count":143,"title":["Sleep and nocturnal acid reflux in normal subjects and patients with reflux oesophagitis."],"prefix":"10.1136","volume":"32","author":[{"given":"N","family":"Freidin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M J","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Boyd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Surratt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R W","family":"McCallum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R K","family":"Mittal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1991,11,1]]},"reference":[{"key":"ref_1","first-page":"376","volume-title":"Pathogenesis of reflux esophagitis. 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J Clin Invest 1980; 65: 256-67.","journal-title":"J Clin Invest"},{"key":"ref_4","first-page":"636","article-title":"Characteristics of transient lower esophageal sphincter relaxation in humans","volume":"252","author":"Mittal, R.K.; McCallum, R.W.","year":"1987","unstructured":"Mittal RK, McCallum RW. Characteristics of transient lower esophageal sphincter relaxation in humans. Am J Physiol 1987; 252: G636-41.","journal-title":"Am J Physiol"},{"key":"ref_5","first-page":"1547","article-title":"Mechanism of gastroesophageal reflux in patients with reflux esophagitis","volume":"307","author":"Dodds, W.J.; Dent, J.; Hogan, W.J.","year":"1982","unstructured":"Dodds WJ, Dent J, Hogan WJ, et al. Mechanism of gastroesophageal reflux in patients with reflux esophagitis. N Engl J7Med 1982; 307: 1547-52."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/S0016-5085(88)80003-9","article-title":"Characteristics and frequency of transient relaxations of the lower esophageal sphincter in patients with reflux esophagitis","volume":"95","author":"Mittal, R.K.; McCallum, R.W.","year":"1988","unstructured":"Mittal RK, McCallum RW. Characteristics and frequency of transient relaxations of the lower esophageal sphincter in patients with reflux esophagitis. Gastroenterology 1988; 95: 593-9.","journal-title":"Gastroenterology"},{"key":"ref_7","article-title":"A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects","author":"Rechtschaffen, A.","year":"1968","unstructured":"Rechtschaffen A, Kales A, eds. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Washington, DC: US Government Printing Office Publications Service, 1968."},{"key":"ref_8","first-page":"326","article-title":"Applied linear statistical models","author":"Netter, J.; Wasserman, W.; Richard, D.","year":"1974","unstructured":"Netter J, Wasserman W, Richard D. Applied linear statistical models. Homewood, IL: Irwin Inc, 1974: 326-35."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1001\/jama.1984.03350090036019","article-title":"The role of prolonged esophageal pH monitoring in the diagnosis of gastroesophageal reflux","volume":"252","author":"Fink, S.M.; McCallum, R.W.","year":"1984","unstructured":"Fink SM, McCallum RW. The role of prolonged esophageal pH monitoring in the diagnosis of gastroesophageal reflux. JAMA 1984; 252: 1160-4.","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/00000658-197610000-00009","article-title":"Patterns of gastroesophageal reflux in health and disease","volume":"184","author":"DeMeester, T.R.; Johnson, L.F.; Joseph, G.J.; Toscan, M.S.; Hall, A.W.; Skinner, D.B.","year":"1976","unstructured":"DeMeester TR, Johnson LF, Joseph GJ, Toscan MS, Hall AW, Skinner DB. Patterns of gastroesophageal reflux in health and disease. Ann Surg 1976; 184: 459-69.","journal-title":"Ann Surg"},{"key":"ref_11","first-page":"2","article-title":"The first night effect: an EEG study of sleep","volume":"1966","author":"Agnew, H.W.; Webb, W.B.; William, R.L.","unstructured":"Agnew HW, Webb WB, William RL. The first night effect: an EEG study of sleep.Psychophysiology 1966: 2: 263-6.","journal-title":"Psychophysiology"},{"key":"ref_12","first-page":"215","article-title":"Is there a first night effect?","volume":"9","author":"Coble, P.; McPartland, R.J.; Silva, W.J.; Kupfer, D.J.","year":"1974","unstructured":"Coble P, McPartland RJ, Silva WJ, Kupfer DJ. Is there a first night effect? (A Revisit). Biol Psychiatry 1974; 9: 215-9.","journal-title":"(A Revisit). Biol Psychiatry"},{"key":"ref_13","first-page":"814","article-title":"Effect of sleep on swallowing, esophageal peristalsis, and acid clearance","volume":"86","author":"Orr, W.C.; Johnson, L.F.; Robinson, M.C.","year":"1984","unstructured":"Orr WC, Johnson LF, Robinson MC. Effect of sleep on swallowing, esophageal peristalsis, and acid clearance. Gastroenterolog 1984; 86: 814-9.","journal-title":"Gastroenterolog"},{"key":"ref_14","first-page":"159","article-title":"Influence of vagi cooling on esophageal function","volume":"232","author":"Ryan, J.P.; Snape, W.J.; Cohen, S.","year":"1977","unstructured":"Ryan JP, Snape WJ, Cohen S. Influence of vagi cooling on esophageal function. Amj Physiol 1977; 232: 159-64.","journal-title":"Amj Physiol"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1139\/y85-022","article-title":"Esophageal peristalsis in the cat: the role of central innervation assessed by transient vagal blockage","volume":"63","author":"TY, Reynolds R.P.E.Sharkawy; NE, Diamant","year":"1985","unstructured":"Reynolds RPE Sharkawy TY, Diamant NE. Esophageal peristalsis in the cat: the role of central innervation assessed by transient vagal blockage. CanJ7 Physiol Pharmocol 1985; 63: 122-30.","journal-title":"CanJ7 Physiol Pharmocol"},{"key":"ref_16","first-page":"890","article-title":"Abolition of gas reflux and transient lower esophageal sphincter relaxation by vagal blockade","volume-title":"the dog. Gastroenterology 1986; 91","author":"Martin, C.J.; Patrikios, J.; Dent, J.","unstructured":"Martin CJ, Patrikios J, Dent J. Abolition of gas reflux and transient lower esophageal sphincter relaxation by vagal blockade in the dog. Gastroenterology 1986; 91: 890-6."},{"key":"ref_17","first-page":"595","article-title":"Motorfunctions ofthe pharynx and oesophagus","volume-title":"ofthe gastrointestinal tract. Vol 1","author":"Christensen, J.","year":"1987","unstructured":"Christensen J. Motorfunctions ofthe pharynx and oesophagus. In: Johnson JR ed. Physiology ofthe gastrointestinal tract. Vol 1. 2nd ed. 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Esophageal motor events at the occurrence of acid reflux and during endogenous acid exposure in healthy subjects and in patients with oesophagitis. Gut 1985; 26: 336-41."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/0016-5085(81)90716-2","article-title":"Gastric emptying in patients with gastroesophageal reflux","volume":"80","author":"McCallum, R.W.; Berkowitz, D.M.; Levin, E.","year":"1980","unstructured":"McCallum RW, Berkowitz DM, Levin E. Gastric emptying in patients with gastroesophageal reflux. Gastroenterology 1980; 80:285-90.","journal-title":"Gastroenterology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/0016-5085(87)90849-3","article-title":"Identification and mechanism of delayed acid clearance in subjects with hiatus hernia","volume":"92","author":"Mittal, R.K.; Lange, R.C.; McCallum, R.W.","year":"1987","unstructured":"Mittal RK, Lange RC, McCallum RW. 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