Improvement of nighttime gastroesophageal reflux symptoms with sleep positional therapy using a smartwatch app

Summary Nighttime gastroesophageal reflux symptoms affect sleep quality and daytime functioning. The aim of this study is to investigate if sleep positional therapy, using a smartwatch app, can reduce nighttime gastroesophageal reflux symptoms by training patients to avoid sleeping in right lateral decubitus position. Patients with nighttime gastroesophageal reflux symptoms were included. During a two-week treatment period a smartwatch app was used that was designed to vibrate when the subject is lying in right lateral decubitus position, prompting patients to change their sleeping position. Symptoms and sleep position were measured at baseline, during and after the treatment period. Primary outcome was a change in total nighttime gastroesophageal reflux symptoms measured by the Nocturnal Gastroesophageal Reflux Disease Symptom Severity and Impact Questionnaire (N-GSSIQ). In total 18 patients with nighttime gastroesophageal reflux symptoms were included (mean age 51 years; 66,7% female). Sleep positional therapy reduced gastroesophageal reflux symptoms (N-GSSIQ score) significantly (39.3 to 24.1; P = 0.003). After sleep positional therapy patients were sleeping less in right lateral decubitus position (31.8% vs. 8.1%; P = 0.002) and more in left lateral decubitus position compared to baseline (39.9% vs. 61.3%; P = 0.002). Patients reported more reflux-free nights and less nights with poor sleep quality after sleep positional therapy (5.0 vs. 10.2; P 0.001 and 6.0 vs. 2.0; P 0.001). Sleep positional therapy by a smartwatch app stimulates patients to avoid sleeping in right lateral decubitus position, thereby alleviating nighttime gastroesophageal reflux symptoms improving the number of reflux-free nights.