Gastroesophageal reflux disease (GERD) is a highly prevalent disorder in all Western countries and, in recent years, the prevalence has substantially increased in developing countries. In parallel, there is a remarkable increase of GERD-related fatal and nonfatal complications although these complications are rare on a global scale. GERD is defined by the augmented exposure of esophageal mucosa to acidic gastric content. This is associated with relevant symptoms or mucosal lesions. Symptoms do not include the typical acid-related symptoms (heartburn, acid regurgitation) but a number of atypical symptoms and even disturbances of sleep. There is now emerging evidence that impairment of sleep quality of patients with GERD is an important factor for the reduced quality of life in these patients. On the other hand, sleep and sleep disturbances are linked to the mechanisms that determine the severity of reflux. A number of other factors may contribute to the manifestation of GERD. Nutritional factors are believed to aggravate acidic reflux either by delaying gastric emptying or diminishing the pressure of the lower esophageal sphincter. However, lifestyle modifications such as dietary modifications are believed important but rarely sufficient for the long-term management. Sleeping with an elevated head is a widely used advice that is not easy to follow and has not been proven effectively with regard to the long-term outcome. Thus, medication is usually necessary for symptom control. Reduction of acid secretion with proton pump inhibitors is now mainstream treatment and 8-week complete remission rates (healing of lesions and control of symptoms) are above 80%.