Correlations between gastroesophageal reflux disease and obstructive sleep apnea

Abstract

Introduction. Obstructive sleep apnea (OSA), also referred to as obstructive sleep apneahypopnea— is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort and is characterized by recurrent episodes of upper airway collapse during sleep. The negative intrathoracic pressure presented in apnea leads to gastroesophageal reflux. Gastroesophageal reflux disease (GERD) occurs when the amount of gastric juice that refluxes into the esophagus exceeds the normal limit, causing symptoms with or without Associated esophageal mucosal injury. Objective. My objective is to make correlations between OSA and GERD in a group of Romanian and French patients with OSA and GERD symptoms. Materials, methods. I studied 100 patients, 44 women and 56 men. The diagnosis of OSA was established by overnight polysomnography. The severity of OSA was estimated by IAH (apneahypopnea index). To evaluate GERD symptoms I used GERD questionnaire. Others parameters that were observed were the age, sex, alcohol consumption (g/day), body mass index (BMI), day somnolence expressed by Epworth scale and the activity by Dijon scale. The statistics were made in Excel 2016 and SPSSv.20. The correlations were interpreted with the Pearson index (r).Results In the studied group were 44 women and 56 men. The average age was 52,32 years, average IAH for Romanian group was 32.56/h, average Epworth score for the whole group was 8.85 points, the average BMI = 29,4 kg/ m2 (34,03 for Romanians), the average GERDQ score was 9,3 points and the average Dijon score was 12.3 points. The correlation between GERDQ and IAH was significantly positive with r = 0.35. IAH was strongly correlated with BMI (r = 0.525).GERDQ has strong correlations with BMI for Romanians but not for French patients (r = 0.45 vs. r = -0.21). The most powerful positive correlation was between GERDQ and the alcohol consumption (r =0.428) especially for the Romanian patients. Epworth was correlated with BMI for the whole group (r = 0,3) and with the age (r = 0.34), especially for the French group. (r = 0.65) Also GERDQ and Epworth scale were negatively correlated with Dijon scale. DISCUSSIONS. Researchers in North Carolina conducted a study in 181 patients with sleep apnea and nighttime GERD symptoms in 2003 and the conclusion was that the treatment with nCPAP decreased the frequency of nocturnal GERD by 48%. Also there are studyes suggesting that the treatment with IPP for GERD decreases the number of apneas. Conclusions 1. Obesity is a main risk factor for OSA and GERD. 2. Men present more severe GERD and OSA than women for the Romanian group. 3. GERD is more severe at the Romanian patients who drink more alcohol. 4. GERD is more severe if the patients have more severe OSA.