Scientists have discovered that sleeping with a low pillow height significantly increases the risk of laryngopharyngeal reflux (LPR) in patients suffering from gastro-oesophageal reflux disease (GORD), according to a recent study published in the European Medical Journal. This finding offers a simple yet effective way to improve symptom control and quality of life for millions worldwide who suffer from difficulties caused by acid reflux reaching the throat.
LPR occurs when stomach acid travels upward to the throat, leading to symptoms such as hoarseness, chronic cough, and throat irritation, distinct from typical heartburn associated with GORD. Understanding modifiable lifestyle factors that exacerbate LPR has been challenging, but this study highlights sleep position, specifically pillow height, as a critical risk element alongside behaviors like lying down soon after eating and dietary habits.
The research team at Yijishan Hospital of Wannan Medical College in China conducted a case-control study enrolling 323 GORD patients, of whom 131 had LPR, and 225 healthy controls. They evaluated multiple lifestyle variables—including diet, meal timing, stress, and various sleeping behaviors—using detailed patient questionnaires and medical record analysis. Sedated upper endoscopy combined with laryngeal examination was employed to objectively assess inflammation related to reflux.
Low pillow height emerged as the strongest independent risk factor for developing LPR among GORD patients, surpassing other factors such as anxiety, eating speed, and high-fat diets. The researchers developed a predictive model incorporating six key risk factors that achieved strong accuracy (area under the curve of 0.775) in identifying patients at high risk for LPR. This model, along with endoscopic findings, provides valuable tools for early diagnosis and targeted prevention.
Lead researchers emphasized that simple, non-pharmacological interventions like elevating pillow height during sleep and avoiding lying supine immediately after meals could substantially reduce reflux symptoms. These lifestyle changes might enhance therapeutic outcomes for a condition that is often resistant to medication and associated with anxiety and impaired quality of life.
REFERENCE: Cao, H., Yin, H., Li, L. et al. Low pillow height is associated with LPR among patients with GERD: a retrospective single-center study. BMC Gastroenterol 25, 778 (2025). https://doi.org/10.1186/s12876-025-04367-z
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