A NEW study has found that sleeping with a low pillow height is strongly associated with laryngopharyngeal reflux (LPR) in patients with gastro-oesophageal reflux disease (GORD), a finding that could help improve symptom control and quality of life for millions of sufferers worldwide.
Sleep Position May Play a Critical Role
The research, conducted at Yijishan Hospital of Wannan Medical College in China, analyzed 323 GORD patients and 225 healthy controls to explore lifestyle and behavioral factors that increase the risk of LPR — a condition where stomach acid reaches the throat, causing hoarseness, chronic cough, and throat irritation.
Among GORD patients, 131 also had LPR, while 192 had GORD alone. Researchers compared various lifestyle habits including diet, meal timing, stress, and sleep behavior. Notably, low pillow height emerged as the strongest independent risk factor for developing LPR among GORD patients.
Other factors included lying down soon after meals, anxiety, eating too fast, overeating, and a high-fat diet, but none had as large an effect as pillow height.
A Predictive Model for High-Risk Patients
The team developed a six-factor predictive model using these key variables, which achieved an area under the curve (AUC) of 0.775, indicating strong accuracy in identifying GORD patients at high risk of developing LPR.
Sedated upper endoscopy, combined with laryngeal examination, also proved valuable in detecting inflammation linked to reflux, supporting its use in clinical assessment.
Implications for GERD Management
GORD combined with LPR is notoriously difficult to manage, often showing poor response to medication and contributing to anxiety and reduced quality of life. The findings suggest that simple, non-pharmacological measures, such as elevating pillow height and avoiding supine rest after meals, could meaningfully reduce symptoms.
Reference
Cao H et al. Low pillow height is associated with LPR among patients with GERD: a retrospective single-center study. BMC Gastroenterol. 2025;DOI: 10.1186/s12876-025-04367-z.
