An under-diagnosed problem affecting sleep

[tatt]

When I was waking at 4a.m my gp diagnosed depression. It was only when I lost my voice that I was finally diagnosed with laryngopharyngeal reflux because I didn't experience any heartburn in the day and wasn't aware of what was waking me at night. Laryngopharyngeal reflux is sometimes known as silent reflux because the symptoms are subtle.

If you have this condition raising the head of the bed - by 8 inches if possible, although most people cant manage more than 4 inches at first, may be enough to help keep the acid where it belongs and allow you to sleep better. We had a divan bed so taking off the wheels and putting scrap bits of wood under the top of the bed showed this would help me. We then got a builders yard to cut a piece of wood to the width of the bed. I have a heavy bed so we have a second, lower, piece about two thirds of the way down the bed to give additional support. This cost us about £10 (less than 20$).

It is possible to take omeprazole or lansoprazole if the reflux is really bad and a trial of this drug may also improve sleep.

 

[Cort]

When I was waking at 4a.m my gp diagnosed depression. It was only when I lost my voice that I was finally diagnosed with laryngopharyngeal reflux because I didn't experience any heartburn in the day and wasn't aware of what was waking me at night. Laryngopharyngeal reflux is sometimes known as silent reflux because the symptoms are subtle.

If you have this condition raising the head of the bed - by 8 inches if possible, although most people cant manage more than 4 inches at first, may be enough to help keep the acid where it belongs and allow you to sleep better. We had a divan bed so taking off the wheels and putting scrap bits of wood under the top of the bed showed this would help me. We then got a builders yard to cut a piece of wood to the width of the bed. I have a heavy bed so we have a second, lower, piece about two thirds of the way down the bed to give additional support. This cost us about £10 (less than 20$).

It is possible to take omeprazole or lansoprazole if the reflux is really bad and a trial of this drug may also improve sleep.

Very interesting...it was the loss of voice that did it.....I imagine you had it long before that happened.Another probably rarely diagnosed co morbid disorder...

This is not an easy condition to diagnose:

As there are multiple potential etiologies for the respiratory and laryngeal symptoms, establishing LPR as the cause based on symptoms alone is unreliable. Laryngoscopic findings such as erythema, edema, laryngeal granulomas, and interarytenoid hypertrophy have been used to establish the diagnosis; but these findings are very nonspecific, and have been described in the majority of asymptomatic subjects undergoing laryngoscopy.[12] Response to acid-suppression therapy has been suggested as a diagnostic tool for confirming diagnosis of LPR, but studies have shown that the response to empirical trials of such therapy (as with proton-pump inhibitors) in these patients is often disappointing.[13] Several studies have emphasized the importance of measuring proximal esophageal, or, ideally, pharyngeal acid exposure in patients with clinical symptoms of LPR, to document reflux as the cause of the symptoms.[14][15]

I wonder if is a good number of those who found raising their bed helped had this condition.

Has your health improved much since you increased the height of your bed? Are you sleeping later?

 

[tatt]

I stopped waking up at 4 a.m as well as getting my voice back. Probably had had it for many years before diagnosis especially as I had problems swallowing at one point and my doctors found no obvious reason for it. If I start waking in the night now I know I need to take medication.

I'm lucky in that I do respond to medication, although not if I took it as prescribed (in the morning), I need to take it in the evening. I wonder when patients took it in clinical studies.

Raising the head of the bed helps people with other conditions too - helped my husband with his sleep apnoea for a time before it got bad enough to need CAP.

 

[Karen PT]

In the US, it is called gastro-esophogeal reflex disease/disorder (GERD). It can also cause sinus problems. So if you have sinus troubles, have your doctor look for signs of reflux in your throat.

 

[tatt]

had sinus problems for years - my doctors still didnt think to look for it until I mentioned it to them.

 

[Zapped]

When I was waking at 4a.m my gp diagnosed depression. It was only when I lost my voice that I was finally diagnosed with laryngopharyngeal reflux because I didn't experience any heartburn in the day and wasn't aware of what was waking me at night. Laryngopharyngeal reflux is sometimes known as silent reflux because the symptoms are subtle...
It is possible to take omeprazole or lansoprazole if the reflux is really bad and a trial of this drug may also improve sleep.

Thanks for the post. I have GERD but have not connected the source of my frequent hoarseness to your reference.
I'll sure get the Larynx related checked!

BTW, You might grab a copy of a Kindle Book (Amazon), from a prolific medical author endorsed by Andrew Weil, Harvard MD. - if only to check the chapter on his supplements recommendations for the gut and these related problems. (See below.)

He credibly reviews ~15+/- specific, readily available supplements (and other home treatments). While you likely know some of this stuff already you can cover the supplement material in 20 minutes.

You'll be surprised at a couple of his recommendations (with references) that I found make significant improvements in GERD and IBS. For example, he states "Melatonin also reduces gastric acid production (to a milder degree than proton pump inhibitors [PPIs], thankfully). A recent study found melatonin to be more effective than PPIs in the treatment of GERD", (and he cites the study.)

I otherwise replaced Protonix for GERD and got major relief from other IBS symptoms this past week. (Maybe that hoarseness will now subside!)

Please post results if you give it a go.

Title: 'The Inside Tract', Gerald E. Mullins, MD (Gastroenterologist). (It's only $3, as it's a 2011 edition, and he has since published others.)

 

[tatt]

thanks for the suggestion. Melatonin isn't freely available in the uk so I would have to buy it abroad as I wont risk my card details on the sort of website that would post it to the uk. Not planning to travel for a while though. I no longer have the nice gp who let me try omeprazole (and would possibly have prescribed melatonin as it can be used for insomnia, my current gp would probably suggest something else).

If you have GERD and hoarseness you should ask about the possibility as there is a very small risk of cancer with untreated LR.

 

[Zapped]

If you have GERD and hoarseness you should ask about the possibility as there is a very small risk of cancer with untreated LR.

I realize that. In fact, an old classmate recently died of Esoph cancer. Scary!

I sure feel for you PWC's and other limited patients across the pond re health care not being responsive to some
serious needs. For years I have come across stories of restrictive medical practices in the U.K., including the
championing efforts before Parliament by famed Canadian ME pioneer Dr. Byron Hyde.

In a nutshell, what's your take on the bottom of this problem; tax related, i.e. preferential allocation, political?

BTW, spent 10 vacation days in London in and around South Kensington and the City surrounds. 'Loved it but hardly scratched the surface. The pound coinage currency made it way too easy to reach down and think we were paying 'only a coin' for this or that - right, and very expensive ones by the end of the day! Regrettably, CFS likely inhibits any future returns...but I still have a number of those pricey pocket souvenirs I failed to redeem, just in case