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Link Between Acid Reflux and Sleep Apnea Challenged

NORTHBROOK, Ill -- April 6, 2010 -- New research published in the April issue of the journal CHEST suggests that a causal link between gastroesophageal reflux (GERD) and obstructive sleep apnea (OSA) may not exist.

GERD is thought to be induced by decreasing intraesophageal pressure during obstructive sleep apnea (OSA). However, pressure changes in the upper esophageal sphincter (UES) and gastroesophageal junction (GEJ) pressure during OSA events have not been measured.

Shiko Kuribayashi, MD, Dysphagia Institute, Division of Gastroenterology, and Hepatology Medical College of Wisconsin, Milwaukee, Wisconsin, and colleagues studied the sleep events of 9 patients with GER without OSA, 6 patients with OSA without GER, 11 patients with OSA and GER, and 15 control subjects.

The researchers recorded UES, GEJ, oesophageal body (ESO), and gastric pressures by high-resolution manometry; pharyngeal and oesophageal reflux events by impedance and pH recordings; and sleep stages and respiratory events using polysomnography.

End-inspiration UES, GEJ, ESO, and gastric pressures over intervals of OSA were averaged in patients with OSA and compared with average values for randomly selected 10-s intervals during sleep in controls and patients with GERD.

Although GER is thought to be induced by decreasing intraesophageal pressure during OSA, study results showed that esophageal pressures progressively increased during OSA.

However, end-inspiratory UES and GEJ pressures progressively increased during OSA, and at the end of OSA events were significantly higher than at the beginning (P < .01).

The incidence of GER during sleep in patients with OSA and GER did not differ from the remaining 3 groups. Researchers speculate that OSA may not induce GER or other reflux events.

Source: American College of Chest Physicians, April 6, 2010

 

By Mortin - Copyright 2010
Last modification 06/04/2010