Acid regurgitation tends to aggravate during sleep at night and affects the patients’ quality of life.1 Ranitidine, an H2-receptor antagonist, is known to reduce nocturnal acidity.2

A recent study evaluated the impact of spontaneous sleep positions on nocturnal gastroesophageal reflux.3

Patients referred for ambulatory pH-impedance reflux monitoring were evaluated for simultaneous sleep positions. A sleep position measurement device was used which measured left, right, supine, and prone positions. A total of 57 patients were recruited in the study.

• The acid exposure time was significantly lesser in the left lateral position (median 0.0%), compared to the right lateral position (median 1.2%, P = 0.022) and supine position (median 0.6%, P = 0.022).
• There was significantly shorter esophageal acid clearance time in the left lateral decubitus position (median 35 seconds), when compared with supine (median 76 seconds, P = 0.030) and right lateral positions (median 90 seconds, P = 0.002).

Left lateral position seems to be tied to significantly shorter nocturnal acid exposure time and quicker esophageal acid clearance.

References

1. Huang HC, Fang SY. [A Systematic Review of the Literature Related to Elevating the Head of the Bed for Patients With Gastroesophageal Reflux Disease: Applications in Patients After Esophageal Cancer Surgery]. Hu Li Za Zhi. 2016 Jun;63(3):83-93.
2. Merki HS, Witzel L, Walt RP, et al. Comparison of ranitidine 300 mg twice daily, 300 mg at night and placebo on 24-hour intragastric acidity of duodenal ulcer patients. Aliment Pharmacol Therap. 1987;1(3):217-223.
3. Schuitenmaker JM, van Dijk M, Nijhuis RABO, et al. Associations Between Sleep Position and Nocturnal Gastroesophageal Reflux: A Study Using Concurrent Monitoring of Sleep Position and Esophageal pH and Impedance. Am J Gastroenterol. 2021 Dec 20.