Impact of sleep and movement on gastro-oesophageal reflux in healthy, newborn infants.

Seventy four normal, healthy newborn babies were studied to examine the relationship between gastro-oesophageal reflux, sleep state, and movement. Multichannel pen recordings were made to determine sleep state, movement, breathing, and reflux. The mean number of reflux episodes per hour was highest in wakefulness, followed by active and indeterminate sleep. In quiet sleep reflux rarely occurred. The mean duration of reflux episodes per hour was longest in active sleep followed by wakefulness, indeterminate and quiet sleep. There was a strong positive correlation between duration of reflux and movement time for wakefulness, active and indeterminate sleep. Movement preceded 88% of all reflux episodes. Physiological reflux occurs in most newborn infants but is clinically inapparent. The results suggest that state and movement are related to the incidence and duration of reflux. Sleep state is therefore an important variable in determining normal values for reflux in infancy since developmentally the amount of sleep time lessens but quiet sleep proportionally increases.