Power spectral analysis of the sleep electroencephalogram in heartburn patients with or without gastroesophageal reflux disease: A feasibility study

GOALS: Determine the feasibility of using power spectrum of the sleep electroencephalogram (EEG) as a more sensitive tool than sleep architecture to evaluate the relationship between gastroesophageal reflux disease (GERD) and sleep. BACKGROUND: GERD has been shown to adversely affect subjective sleep reports but not necessarily objective sleep parameters. STUDY: Data were prospectively collected from symptomatic patients with heartburn. All symptomatic patients underwent upper endoscopy. Patients without erosive esophagitis underwent pH testing. Sleep was polygraphically recorded in the laboratory. Spectral analysis was performed to determine the power spectrum in 4 bandwidths: δ (0.8 to 4.0Hz), θ (4.1 to 8.0Hz), α (8.1 to 13.0Hz), and β (13.1 to 20.0Hz). RESULTS: Eleven heartburn patients were included in the GERD group (erosive esophagitis) and 6 heartburn patients in the functional heartburn group (negative endoscopy, pH test, response to proton pump inhibitors). The GERD patients had evidence of lower average δ-power than functional heartburn patients. Patients with GERD had greater overall α-power in the latter half of the night (3 hours after sleep onset) than functional heartburn patients. No significant differences were noted in conventional sleep stage summaries between the 2 groups. CONCLUSIONS: Among heartburn patients with GERD, EEG spectral power during sleep is shifted towards higher frequencies compared with heartburn patients without GERD despite similar sleep architecture. This feasibility study demonstrated that EEG spectral power during sleep might be the preferred tool to provide an objective analysis about the effect of GERD on sleep.