Sleep Aid May Lead to More Acid Reflux Exposure

In patients with acid reflux, acid events lasted much longer after taking zolpidem than placebo
By Eric Metcalf
HealthDay Reporter

FRIDAY, Sept. 18 (HealthDay News) -- The sleep-inducing drug zolpidem may help patients with gastroesophageal reflux sleep through reflux events, increasing their acid exposure, according to research published in the September issue of Clinical Gastroenterology and Hepatology.

Gregg S. Gagliardi, M.D., of the Thomas Jefferson University Hospital in Philadelphia, and colleagues analyzed data from eight healthy controls and 16 subjects with gastroesophageal reflux, who underwent two separate nocturnal sleep studies. Participants were randomly assigned to receive zolpidem or placebo shortly before bedtime in a double-blind, crossover fashion on separate nights.

Overall, the researchers found that acid reflux led to sleep arousal or awakening 89 percent of the time in subjects who took placebo, but 40 percent of the time in those who took zolpidem. Acid reflux events in reflux patients given zolpidem lasted substantially longer compared to placebo (363.3 versus 37.8 seconds). In reflux patients taking zolpidem, the mean acid clearance time in response to a reflux event was 49.2 seconds with an arousal, compared to 630.6 seconds with no arousal.

"Hypnotic medications should be used with caution in patients with known supine gastroesophageal reflux disease. Gastroesophageal reflux disease should be suspected and investigated as a cause in patients with insomnia or disturbed sleep. Furthermore, use of hypnotic medications should be restricted during 24-hour pH testing to avoid false positive results," the authors conclude.

A co-author reported a financial relationship with Sanofi-Aventis, and an AstraZeneca program provided some support for the research.

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