Simadibrata DM, Lesmana E, Amangku BR, Wardoyo MP, Simadibrata M. Left lateral decubitus sleeping position is associated with improved gastroesophageal reflux disease symptoms: A systematic review and meta-analysis. World J Clin Cases 2023; 11(30): 7329-7336 [PMID: 37969463 DOI: 10.12998/wjcc.v11.i30.7329]
Corresponding Author of This Article
Marcellus Simadibrata, FACG, MD, PhD, Full Professor, Professor, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jl Salemba IV, Jakarta 10430, Indonesia. prof.marcellus.s@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2023; 11(30): 7329-7336 Published online Oct 26, 2023. doi: 10.12998/wjcc.v11.i30.7329
Left lateral decubitus sleeping position is associated with improved gastroesophageal reflux disease symptoms: A systematic review and meta-analysis
Daniel Martin Simadibrata, Elvira Lesmana, Bagus Ramasha Amangku, Muhammad Prasetio Wardoyo, Marcellus Simadibrata
Daniel Martin Simadibrata, Elvira Lesmana, Bagus Ramasha Amangku, Muhammad Prasetio Wardoyo, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia
Daniel Martin Simadibrata, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
Daniel Martin Simadibrata, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
Marcellus Simadibrata, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia
Author contributions: Simadibrata DM contributed to study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript; Lesmana E contributed to study concept and design; acquisition of data; drafting of the manuscript; Amangku BR contributed to acquisition of data; drafting of the manuscript; Wardoyo MP contributed to acquisition of data; drafting of the manuscript; Simadibrata M contributed to study concept and design; acquisition of data; drafting of the manuscript; critical revision of the manuscript.
Conflict-of-interest statement: All authors have no conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2020 Checklist, and the manuscript was prepared and revised according to the PRISMA 2020 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marcellus Simadibrata, FACG, MD, PhD, Full Professor, Professor, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jl Salemba IV, Jakarta 10430, Indonesia. prof.marcellus.s@gmail.com
Received: August 7, 2023 Peer-review started: August 7, 2023 First decision: September 14, 2023 Revised: September 24, 2023 Accepted: October 8, 2023 Article in press: October 8, 2023 Published online: October 26, 2023
ARTICLE HIGHLIGHTS
Research background
Sleeping in the left lateral decubitus (LLD) has been shown to decrease nocturnal reflux in patients with gastroesophageal reflux disease (GERD) compared to right lateral decubitus (RLD) sleep position and supine.
Research motivation
This is the first systematic review that summarizes the association between sleeping in the LLD position and nocturnal reflux in patients with GERD.
Research objectives
The study aimed to summarize the evidence on sleep position for treating nocturnal reflux and GERD symptoms in GERD patients.
Research methods
We searched for randomized and nonrandomized evidence assessing LLD sleep position in comparison to RLD and supine position in reducing nocturnal reflux in patients with GERD. A meta-analysis was done to pool outcomes such as acid exposure time (AET) and acid clearance time (ACT).
Research results
Two nonrandomized studies showed decreased AET and ACT in LLD sleep position in comparison to RLD and supine. There was no difference in AET and ACT between RLD sleep position and supine. A randomized controlled trial investigating the use of electronic sleep positional therapy, which increased the duration of LLD sleep and decreased the duration of RLD sleep compared to sham, showed nocturnal symptom improvements.
Research conclusions
Current evidence suggests that sleeping on the left side could reduce nocturnal reflux and improve GERD-related quality of life, therefore warranting interventions that promote LLD sleep position.
Research perspectives
LLD sleep should be recommended for GERD patients, especially those who experience nocturnal symptoms. Studies should look into the practicality and feasibility of using an electronic sleep positional therapy and whether patients can tolerate it in real life.
