Night-Time Acid Reflux Can Impact Sleep, New Studies Reveal

According to results of a survey presented at the 72nd Annual Scientific Meeting of the American College of Gastroenterology, nighttime acid reflux, along with some of less typical manifestations or symptoms of gastroesophageal reflux disease ( GERD ) , is associated with significant sleep impairment.

In a recent national survey, researchers assessed the prevalence of sleep impairment among people with GERD and people without GERD based on response to an Internet survey of a general population of U. S. adults. Using a validated GERD screening tool, 701 respondents were identified with GERD and the remaining were controls. Bonnie Dean, MPH, PhD, of Cerner LifeSciences, Ronnie Fass, MD of University of Arizona and their research team found that sleep impairment was more common among people with GERD ( 41. 9 percent ) than those without GERD ( 19. 4 percent ) . Researchers found that 49. 5 percent of respondents with nighttime GERD reported sleeping poorly often or most of the time, compared to 36. 7 percent of people with daytime GERD.

Using survey, researchers also assessed sleep impairment among patients experiencing frequent nighttime atypical manifestations of GERD. In this case, Dr. Dean and her colleagues evaluated subgroup of respondents with GERD, as identified using the validated GERD screener. They found that atypical manifestations or symptoms of GERD ( i. e. coughing, sore throat, snoring, wheezing, choking, and chest pain ) were common among those with acid reflux. Of GERD patients, 74 percent had at least one nighttime atypical manifestation. For almost every daytime and nighttime atypical manifestation assessed, more than 20 percent of GERD patients reported their occurrence as frequent ( more than 2 days or nights per week ) . Researchers also found that sleep impairment was more common among GERD patients with atypical manifestations compared to GERD patients with only typical or classic symptoms such as heartburn and acid regurgitation. For eight of the nine nighttime atypical manifestations assessed, proportion of GERD cases reporting sleep impairment was significantly higher for GERD cases with the atypical manifestation compared with GERD cases without atypical manifestation.

" Awareness of nighttime reflux, atypical manifestations, and associated sleep complaints should allow more complete evaluation and treatment of GERD patients, " said Doctor Dean about this project.

Tips for Calming Nighttime Acid Reflux Heartburn and other gastroesophageal reflux disease ( GERD ) symptoms experienced during the night commonly cause sleep disturbances, including arousal from sleep, increased wakefulness and overall poor sleep quality.

Here are several tips to help reduce nighttime acid reflux so we can sleep better:

* Sleep with your head and shoulders elevated * Wear loose-fitting clothes * Wait 2 to 3 hours after eating to go to sleep * Avoid foods that trigger heartburn

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For more information and to order free pamphlets and a free video about heartburn and GERD, visit the ACG web site.

About American College of Gastroenterology

Founded in 1932, American College of Gastroenterology ( ACG ) is an organization with an international membership of more than 10, 000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of College is to serve evolving needs of physicians in delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients.

The ACG is committed to providing accurate, unbiased and up-to-date health information. Visit ACG Web site American College of Gastroenterology to access educational resources for patients and their families spanning broad range of digestive diseases and conditions - both common and not-so-common. Organized by disease, state and organ system, these educational materials, developed by ACG physician experts, are offered for the information and benefit of patients and public.

Source: Rosanne Riesenman American College of Gastroenterology

Useful medical advises

Doxepin - how with it.

uses of Doxepin

Doxepin is used to treat mental/mood problems such as depression, anxiety and bipolar disorder. It may help improve mood and feelings of well-being, relieve anxiety and tension, help we sleep better, and increase your energy level. Doxepin belongs to a class of medications called tricyclic antidepressants. It works by affecting balance of certain natural chemicals ( neurotransmitters ) in brain.

how to use of Doxepin

Read Medication Guide available from your pharmacist. Consult your doctor or pharmacist if we have any questions.

Take Doxepin by mouth, usually 1 to 3 times daily or as directed by your doctor. If we take it only once a day, take it at bedtime to help reduce daytime sleepiness. The dosage is based on your age, medical condition and response to therapy. Your doctor may start we at a low dose and gradually increase your dose over several weeks. Follow your doctor's instructions carefully.

Use dropper that comes with the medication to measure out prescribed amount. Just before taking, mix drug with half a glass ( 4 ounces or 120 milliliters ) of water, whole/skim milk, or orange, grapefruit, tomato, prune or pineapple juice, and drink all of the mixture. Don't mix with soda or other carbonated beverages. If we are taking Doxepin in combination with liquid methadone, we may mix both drugs with lemonade, orange juice, sugar water, orange drink mix, or plain water, but not grape juice. Mix only what we need for each dose. Don't prepare a supply for future use.

Doxepin doesn't work right away. It may take up to 2 to 3 weeks before we experience the full benefits.

Use Doxepin regularly in order to get most benefit from it. To help we remember, take it at same times each day.

It is important to continue taking Doxepin even if you feel well. Do not suddenly stop taking Doxepin without consulting your doctor. Some conditions may become worse when drug is abruptly stopped. Muscle aches, headaches and worsening anxiety may also occur. Your dose may need to be gradually decreased.

Tell your doctor if your condition persists or worsens.

other used of Doxepin

This section contains uses of Doxepin that aren't listed in the approved professional labeling for drug but that may be prescribed by your health care professional. Use Doxepin for a condition that's listed in this section only if it has been so prescribed by your health care professional.

If directed by your doctor, Doxepin may also be used to treat certain types of pain ( e. g. , peripheral neuropathy, neuropathic pain ) and trouble sleeping.

side effects of Doxepin

See also Warning section.

Drowsiness, dizziness, dry mouth, blurred vision, constipation, fast heartbeat, nausea, vomiting, loss of appetite, changes in taste, weight gain, or trouble urinating may occur while use Doxepin. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

To relieve dry mouth, suck on ( sugarless ) hard candy or ice chips, chew ( sugarless ) gum, drink water, or use a saliva substitute.

Remember that your doctor has prescribed Doxepin because he or she has judged that benefit to we is greater than risk of side effects. Many people using Doxepin don't have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

Tell your doctor immediately if any of these rare but very serious side effects occur:

A very serious allergic reaction to Doxepin is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include:

This isn't a complete list of possible side effects. If we notice other effects not listed above, contact your doctor or pharmacist.

precautions of Doxepin

See also Warning section.

Before taking Doxepin, tell your doctor or pharmacist if we are allergic to it, or to other tricyclic antidepressants ( e. g. , amitriptyline ) , or if we have any other allergies.

Doxepin shouldn't be used if we have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if we have:

Before using Doxepin, tell your doctor or pharmacist your medical history, especially of:

Doxepin may make we drowsy or dizzy or cause blurred vision; use caution engaging in activities requiring alertness or clear vision such as driving or using machinery. Limit alcoholic beverages.

To minimize dizziness and the risk of fainting, get up slowly when rising from a sitting or lying position.

Before having surgery, tell your doctor or dentist that you're taking Doxepin.

Doxepin may make you more sensitive to sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Wear sunblock ( SPF 30 or greater ) and a hat when outdoors.

If we have diabetes, Doxepin may increase your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor immediately if we have symptoms such as increased thirst/urination, shakiness, unusual sweating, or hunger. Your anti-diabetic medication or diet may need to be adjusted.

Depression can lead to thoughts/attempts of suicide. Tell your doctor immediately if we have any suicidal thoughts, worsening depression, or any other mental/mood changes ( including new or worsening anxiety, agitation, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, rapid speech ) . Keep all medical appointments so your doctor can monitor your progress closely and adjust your medication if needed.

Caution is advised when using Doxepin in the elderly because they may be more sensitive to its side effects, especially dizziness, drowsiness, confusion, and difficulty urinating.

Caution is advised when using Doxepin in children. ( See also Warning section. ) Doxepin should be used only when clearly needed during pregnancy. Discuss risks and benefits with your doctor.

Doxepin passes into breast milk and may have undesirable effects on a nursing infant. Breast-feeding while using Doxepin isn't recommended. Consult your doctor before breast-feeding.

interactions of Doxepin

Your healthcare professionals ( e. g. , doctor or pharmacist ) may already be aware of any possible drug interactions and may be monitoring we for it. Do not start, stop or change dosage of any medicine before checking with them first.

Doxepin should not be used with following medications because very serious ( possibly fatal ) interactions may occur:

Avoid taking MAO inhibitors within 2 weeks before and after treatment with Doxepin. In some cases a serious, possibly fatal drug interaction may occur while use Doxepin.

If we are currently using any of these medications listed above, tell your doctor or pharmacist before starting Doxepin.

Other drugs besides Doxepin that may affect the heart rhythm ( QT prolongation in EKG ) include disopyramide, cisapride, halofantrine, pimozide among others. Before taking Doxepin, report all medications you're currently using to your doctor or pharmacist. QT prolongation can infrequently result in serious ( rarely fatal ) fast/irregular heartbeat and other symptoms ( e. g. , severe dizziness, fainting ) that require immediate medical attention. Ask your doctor or pharmacist for more details and for instructions on how you may reduce risk of this effect.

Before using Doxepin, tell your doctor or pharmacist of all prescription and nonprescription/herbal products we may use, especially of:

If we have been taking fluoxetine, wait at least 5 weeks after stopping fluoxetine before starting Doxepin.

Cigarette smoking decreases blood levels of this medication. Tell your doctor if you smoke or if we have recently stopped smoking.

Tell your doctor or pharmacist if we also take drugs that cause drowsiness such as:

Check labels on all your medicines ( e. g. , cough-and-cold products ) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.

Also report use of drugs which might increase seizure risk ( decrease seizure threshold ) when combined with Doxepin such as bupropion, isoniazid ( INH ) , theophylline, or tramadol, among others. Consult your doctor or pharmacist for details.

This document doesn't contain all possible interactions. Therefore, before using Doxepin, tell your doctor or pharmacist of all the products we use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Low costed Doxepin