There's this well-known line, it seems to crop up regularly in TV mystery and crime procedural shows, "There's no such thing as a coincidence." The detective gazes into the middle distance and then, as if my magic, manages to explain why 2 + 2 really does equal 4 this time. It's the type of thing that ought to be true. The cause and effect of any combination of circumstances should always have some kind of logical explanation. Gastroesophageal Reflux Disease (GERD) is a classic example of this in action. If the sphincter into your stomach fails to prevent stomach acid leaking out, it's no coincidence you find your esophagus hurting. That's one of those night and day things. The esophagus is not designed to tolerate the presence of the acid, so. . . But suppose you see two men scratching their head and both are left-handed, does their preference for one hand explain why their heads itch? Obviously not. But, in all situations where two or more facts do appear together, scientists can get very interested to decide whether this is real cause and effect, or just coincidence.

So here comes the question for you to ponder. Does someone with GERD wake up more often during the night? Well, someone with the time and money decided to find out. In a sleep center set up to monitor almost every aspect of what happens when you sleep, some 40 brave volunteers with GERD agreed to be prodded and poked. This included placing a probe in their esophagus. Many might find having a piece of hardware lurking inside them a deterrent to sleep, but let's not go there. As against all the other people monitored for sleep disorders by the center, the 40 with GERD woke three times a night. The others only woke an average of twice, even with sleep disorders. So, being scientists, these busybodies asked the poor sleepers why they had woken. Remarkably, only 15% said they had GERD symptoms. Yet when the researchers looked at the real-time feed from the metal thing in their esophagus, all the volunteers had just experienced an acid reflux episode.

This is too small a sample to be scientifically useful, but it poses a second interesting question. When trying to diagnose a problem, doctors ask their patients for symptoms. But if people are not aware of the acid reflux and it's the cause of their waking, perhaps a lot of insomnia is caused by acid reflux. So here's an entirely unscientific suggestion for you. If you are waking during the night and have no idea why, try taking Aciphex. Unless you have been diagnosed with GERD, this is something of a sledgehammer to crack a nut. But Aciphex cuts down the amount of acid in your stomach and makes it very unlikely any acid will leak into your esophagus while you're lying down. Try it for a week or so. If you sleep through the night, this could be a coincidence. But it might equally be evidence you have GERD and it's the cause of your insomnia. Of course, if you have already been diagnosed with GERD, continue taking the Aciphex and start eating less greasy and spicy food close to your bed time, and raise the head of your bed by putting blocks under the bedposts.