You are viewing the site in preview mode

Skip to main content

Table 1 Characteristics of included studies (n = 5)

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)
  1. aFactorial RCT – 2 factors ranitidine and head-of-bed elevation. bAll groups in hospital and for each group a pillow was allowed