Medicating insomnia when there is reflux can make both much worse

I wonder how many people took note of the extremely important paper published recently in Clinical Gastroenterology and Hepatology. The author marshals twenty additional studies to bolster the finding that, when there is gastroesophageal reflux (GER) disease,  medications for insomnia can make both conditions worse: "Sleep-related GER causes insomnia. Patients might not realize that GER is contributing to their insomnia. When patients complain to their physician about their insomnia, they might not appreciate that GER is a contributing factor, so that instead of intensifying GER therapy during sleep time, they prescribe a non-benzodiazepine hypnotic such as zolpidem. This hypnotic prolongs esophageal acid clearance and delays the arousal response, which can further worsen reflux and thus their insomnia. To avoid this cycle, we should consider sleep-related GER as a possible cause of insomnia and treat GER during the sleep period instead of prescribing a hypnotic medication. This investigation has significant clinical relevance." The author concludes by admonishing doctors: "...common medications used to manage insomnia depress the arousal response that is vital to esophageal refluxate clearance. The data are impressive. Ask your GER patients what happens during sleep!"