Heartburn has long been largely trivialized in the medical community. It has had a bit of a Rodney Dangerfield reputation in that it “gets no respect!” Primary care physicians treat symptoms of heartburn quite readily with antacids and varying degrees of acid-suppressing drugs ranging from H2 blockers to proton-pump inhibitors, depending on the severity and refractoriness of the symptom. The generally excellent clinical response to symptoms of daytime heartburn has contributed to a notable lack of interest in nighttime gastroesophageal reflux (GER). It is a common clinical observation that patients who have been successfully treated for heartburn complaints will spontaneously report that they are sleeping better. This observation has focused the attention of both researchers and clinicians on the relationship between GER and sleep, as well as on the importance of sleep in the patient’s quality of life. Despite this, and the burgeoning body of evidence suggesting that sleep-related GER is an important factor in both the esophageal and respiratory complications of GER, the role of sleep in the clinical presentation of GER has been largely ignored.