The excellent study by Fass and colleagues in the current issue of CHEST (see page 1658) adds considerable support and credibility to the above-noted previous studies. The study included > 15,000 subjects who were participants in other large ongoing clinical trials. The subject pool in this study was several times larger than that of any of the previously cited studies. This alone adds considerable credence to their findings. To their credit, they framed questions concerning nighttime heartburn in a way that would create face validity for the occurrence of this phenomenon during sleep. That is, their question was phrased, “in the past year, how often, on average, have you been awakened during the night with heartburn or indigestion?” An affirmative response to this question would be more likely to reflect an episode of GER that did occur during sleep. In some studies, nighttime heartburn could include an interval of time when an individual may be lying in bed prior to sleep. This study clearly documented a strong relationship between nighttime heartburn and all variables associated with disturbed sleep. Specifically, complaints related to daytime sleepiness appeared to be significantly associated with nighttime heartburn. Also a strong relationship was noted between the symptoms of sleep apnea, such as snoring and daytime sleepiness, and nighttime heartburn. Not surprisingly, body mass index was also a significant predictor of nighttime heartburn. Other variables that have been reported to have a significant association with nighttime heartburn were both self-reported hypertension and asthma as well as the use of benzodiazepines. This is not particularly surprising in view of the now well-established relationship between asthma and GER, as well as among obstructive sleep apnea, GER, and hypertension.5–7 Certainly, the logical conclusion that would be drawn from the increased use of benzodiazepines would be an effort to treat sleep disturbances, particularly insomnia.