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Association between Gastroesophageal Reflux and Sleep Disorder: A Systematic Review and Meta-analysis

Ren C, Zou JJ, Wang Z, Yun JJ, Li YL, Yang Y, Li ZJ, Shen MY

Cellular and molecular neurobiology, 2026

110,417 participants · 1 citation

Abstract

An association between gastroesophageal reflux disease (GERD) and sleep disorder has been reported. However, the magnitude of this association remains poorly understood. Therefore, we aimed to systematically evaluate this relationship. We conducted a comprehensive search for observational studies in eight databases from their inception to February 28, 2025. The characteristics of each study and pooled risk ratio (RR) with corresponding confidence intervals were calculated. Subgroup analyses were performed to explore sources of heterogeneity. A total of eighteen studies involving 110,417 participants met the inclusion criteria and were included in this meta-analysis. Our findings indicate a statistically significant unidirectional association between GERD and sleep disorder (RR = 2.02, 95% CI 1.71 to 2.37). Subgroup analyses consistently demonstrated an association between sleep disorder and GERD regardless of the diagnostic tools used for either condition (P = 0.32 for GERD diagnosis tools and P = 0.80 for sleep disorder diagnosis tools). Sensitivity analysis indicates that the conclusions are highly stable, and GRADEpro evaluation results have a low level of evidence. This meta-analysis reveals a significant correlation between sleep disorder and GERD. More studies under consistent conditions are needed to validate these findings.

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 110,417 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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