From: Head of bed elevation to relieve gastroesophageal reflux symptoms: a systematic review
Study author, year, country, study design | Participants, condition or symptom, setting, age | Intervention | Comparison | Co-interventions | Outcomes assessed in this review |
---|---|---|---|---|---|
Morales et al., 2020, Columbia cross-over RCT [29] | 65 participants with GORD-associated sleep disturbance recruited from a hospital outpatient unit with mean age of 56 years | Bed blocks + PPIs and/or sodium alginate Head-of-bed elevation for 6 weeks at home using 20 cm wooden blocks under bed | Lying flat No Head-of-bed elevation as clinically indicated. | PPIs and/or sodium alginate | Gastroesophageal reflux symptoms Patient preferences Adverse Events |
Huang et al., 2019, Taiwan, cross-over RCT [28] | 14 participants with oesophageal cancer and nocturnal reflux symptoms or reflux esophagitis, recruited from hospital database, with mean age of 62 years | Sleeping on a Wedge + PPIs Using a 20 cm high wedge-shaped pillow at home (with an elevation angle of 20 degree) for 2 weeks + PPIs | PPIs only Not using the pillow for 2 weeks | One pillow of ≤8 cm high | Gastroesophageal reflux symptoms |
Hamilton et al., 1988, United States, cross-over RCT [27] | 15 participants with chronic reflux symptoms and endoscopic evidence of erosive esophagitis, recruited from hospital outpatients, aged between 51 and 74 years | Sleeping on a Wedge Using a 25 cm high foam wedge (with an elevation angle of 22 degree) for one night. Bed blocks Head-of-bed elevated using 20 cm high metal cones under the bed legs for one night. | Lying flat One pillow on a standard hospital bed for one night. b | All anti-reflux medications stopped. Other chronic medications allowed. | Intra-oesophageal pH measurement (Acid exposure/reflux episodes/acid clearance time) Patient preferences |
Harvey et al., 1987, United Kingdom, factorial RCTa [26] | 71 participants with severe gastro-oesophageal reflux, recruited from a hospital, with a median age of 59 years | Bed blocks Head-of-bed raised on 20 cm blocks (with 10% elevation slope) for 6 weeks at home. | Lying flat No bed elevation | Antacid tablets as needed | Gastroesophageal reflux symptoms Adverse Events |
Stanciu et al., 1977, United Kingdom, cross-over trial [25] | 63 participants with typical symptoms of Gastroesophageal reflux, recruited within a hospital, with mean age of 49 years | Bed blocks Head-of-bed elevated with 28 cm blocks during part of the night Sleeping on a Wedge Sitting propped up during part of the night | Lying flat One or two pillows during part of the night | None | Gastroesophageal reflux symptoms Intra-oesophageal pH measurement (Acid exposure/reflux episodes/acid clearance time) |