Treatment of laryngopharyngeal reflux using a sleep positioning device: A prospective cohort study

Objective: Laryngopharyngeal reflux (LPR) symptoms are often resistant to management and cause significant quality of life impairment to patients with this disease. This study assesses the utility of a sleep-positioning device (SPD) in treating LPR. Design: Single center prospective cohort study. Setting: Tertiary medical center Participants: 27 adult patients with diagnosed laryngopharyngeal reflux. Intervention: An SPD consisting of a two-component wedge-shaped base pillow and a lateral positioning body pillow (Medcline, Amenity Health Inc.) was given to patients with a diagnosis of LPR. Subjects slept using the device for at least 6 h per night for 28 consecutive nights. Main outcomes: Primary outcomes were Noctumal Gastroesophageal Reflux Symptom Severity and Impact Questionnaire (N-GSSIQ) and the Reflux Symptoms Index (RSI) survey instrument. Each was collected at baseline, after 14, and after 28 days of SPD use. Results: 27 patients (19 female and 8 male: age 57.1 +/- 12.8, BMI 29.0 +/- 8.1) were recruited. At baseline mean N-GSSIQ was 50.1 +/- 22.4 and mean RSI of 29.6 +/- 7.7. Repeated measure analysis showed that subjects' total N-GSSIQ scores decreased by an average of 19.1 (p = 0.0004) points by two weeks and 26.5 points by 4 weeks (p < 0.0001). RSI decreased an average of 5.3 points by 2 weeks (p = 0.0425) and an average of 14.0 points by 4 weeks (p < 0.0001). Conclusions: In patients with LPR, SPD treatment significantly improves self-reported symptoms of nocturnal re flux as well as symptoms specific to LPR. These results support the therapeutic efficacy of a SPD for patients with LPR. (C) 2017 Elsevier Inc. All rights reserved.