[Two thirds of patients with gastroesophageal reflux have nocturnal symptoms: survey by 562 general practitioners of 36,663 patients].

Objective: Gastroesophageal reflux disease (GERD) affects about 10% of the French population, who have symptoms at least weekly. Nocturnal symptoms are associated with more severe disease. The aim of this study was to determine the prevalence of nocturnal reflux symptoms among patients seeing general practitioners and to assess their consequences on sleep quality.
Methods: For three consecutive days, 562 general practitioners identified among all the adult patients they saw those with GERD symptoms (heartburn or regurgitation) in the previous 3 months and characterized the symptoms.
Results: Prevalence of GERD among the 36663 consulting patients was 8.3%, and 64.6% of them (that is, 5.4% of the general population) reported nocturnal GERD. Patients with nocturnal symptoms did not differ from those with only diurnal symptoms except smokers had a significantly higher rate of nocturnal than diurnal symptoms (28 versus 23%, p=0.0053). GERD symptoms were related to nocturnal awakening in 58.6% of patients, were present in the early morning for 41.6% and in the evening at bedtime for 39.5%. Nocturnal awakening, difficulty in falling asleep and nightmares occurred significantly more frequently in patients with nocturnal symptoms (respectively 56 versus 24%; 41 versus 31%; 14 versus 9%). Likewise, atypical nondigestive symptoms occurred significantly more frequently in patients with nocturnal symptoms (74 versus 51%, p<0.0001). Quality of sleep was considered "poor or very poor" more frequently in patients with nocturnal symptoms (58 versus 34%, p<0.0001).
Conclusion: Approximately 2/3 of GERD patients have nocturnal symptoms that appear to have a significant negative impact on sleep and well-being. These results show the need to evaluate specific therapeutic approaches to reduce sleep disturbances in these patients.