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GERD and Sleep Apnea
I know that GERD and Sleep Apnea often present together, but don't understand why, or just how common it is. Has anyone read up on this enough to give us some direction here? I know it was suggested in another thread here that the inexplicable chronic cough of one of our members might be related to GERD.
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Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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There a numerous studies that show that GERD and OSA go hand in hand. It's interesting to note the treating one helps the other (in both directions). Every time you stop breathing, you create tremendous negative pressure in your chest and throat, which can literally suction up your gastric contents into your throat. When it reaches the throat, it's called laryngo-pharyngeal reflux disease (LPRD). Not only does this irritate the throat and voice box (giving a lump sensation, chronic cough, hoarseness, post-nasal drip, tightening or pain), it causes more swelling in the throat, narrowing the area which leads to more obstruction.
One other explanation is the during an apnea, the phreno-esophageal ligament loosens, allowing stomach juices to leak up easier into the esophagus. Notice I don't use the word acid—that's because stomach contents also include bile, digestive enzymes, and bacteria. This is why in theory, the classic acid "reflux" medications don't do anything for "reflux." They just lower the acidity of the stomach juices.
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Permalink Reply by Quentin Smith on
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I had both together but discovered that I have fructose maladsorption. When I started abstaining from fructose it went completely away.
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Permalink Reply by Duane McDade on
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The main Reason for GERD is what you eat in the Evening and what bedtime snacks you decide to munch on. Choclate is very bad, the glass of milk not to good, anythging saltly, Sodas not good, spicy foods etc, etc.....if you can avoid these foods/snacks you will do much better. RLS can't be Apnea assc. but PLMS are what you are talking about RLS happens when you are awake, PLMS can be part of an arousal process, but sometimes it can something completely different like the parkinsons or some other tic that effects your sleep.
David said:I have had reflux from time to time and just elevate the head of the bed as much as comfortable using an air controlled wedge under the mattress. I keep Pepto Bismol handy as a soothing agent when it occurs and it works but you will probably still be hoarse in the morning. I believe Bruxism and RLS are part of the APNEA package as well.
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Permalink Reply by Richard Morgan on
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I have had GERD for many years, quite severe at times. However, when I started with CPAP I was no longer troubled at night with it. My PCP said perhaps the air rushing in, kept it down. I just know it's been a wonderful side benefit.
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Permalink Reply by Karel McKinney on
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I have both problems, along with a heitial (sp?) hernia. I am noticing I can not use my CPAP all through the night because my stomach seems to fill up with air and it gets uncomfortable and wakes me up. The loud burping the comes next has to be done in the bathroom to keep from waking my husband. So many nights I find I am not using my CPAP at all and I know this is not good. Any suggestions?
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Permalink Reply by Mike on
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Karel, i wonder whether your pressure settings may need to be adjusted. is yours straight CPAP or is it auto adjusting within a prescribed range of pressures?
Karel McKinney said:I have both problems, along with a heitial (sp?) hernia. I am noticing I can not use my CPAP all through the night because my stomach seems to fill up with air and it gets uncomfortable and wakes me up. The loud burping the comes next has to be done in the bathroom to keep from waking my husband. So many nights I find I am not using my CPAP at all and I know this is not good. Any suggestions?
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j n k said:Dr. Park's explanation is excellent.
In layman's terms, part of the connection was once explained to me this way:
When your body is trying desperately to suck air into the lungs, but can't because of the obstructive apnea, it ends up sucking the contents out of your stomach and up into your esophagus (and sometimes beyond) instead. That is one reason that treating OSA often helps fix GERD for some.
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Permalink Reply by Jeffrey Donaldson on
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I have a large hiatal hernia that so far has been treated with meds. It was worse before I got on C-Pap, but also at about the same time, I went on meds for it and elevated the head end of the bed as well. I cannot say with any certainty that C-Pap helped the reflux, but it probably did.
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Mike said:Karel, i wonder whether your pressure settings may need to be adjusted. is yours straight CPAP or is it auto adjusting within a prescribed range of pressures?
Karel McKinney said:I have both problems, along with a heitial (sp?) hernia. I am noticing I can not use my CPAP all through the night because my stomach seems to fill up with air and it gets uncomfortable and wakes me up. The loud burping the comes next has to be done in the bathroom to keep from waking my husband. So many nights I find I am not using my CPAP at all and I know this is not good. Any suggestions?
My machine is adjustable - the clinic has it ramping over 45 minutes due to the hiatal hernia and GERD, I also have been taking Nexium for as long as it has been out and Prevesaid before that. I don't have trouble with the GERD much since being medicated but I am having trouble continuously using my machine. I need to lose about 60 lbs and was excited when they told me that treating the sleep apnea may help with the weight loss. But can't see it helping if I can not use it all night long.
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You have cleared up a mystery for me after going to four doctors about my throat problem. I took Nexium for five months after the first doctor said I had acid reflux, then to gastroenterologist for an endoscopy knowing the Nexium was not helping. No acid reflux! From there I had a throat scope by an ENT doctor and my tongue was swollen in the back causing the passageway to narrow, feeling a lump in my throat, always trying to clear my throat of phlegm, some swallowing difficulties, etc. Next doctor was an allergist....found I was only allergic to cats. He gave me Alestin, a nasal spray plus PolyHiste Forte, a tablet. Both were to dry me up and help the phlegm problem. Then to the sleep apnea doctor where I was diagnosed with sleep apnea. So I must have laryngopharyngeal reflux!
Thanks for your diagnosis which fit me perfectly.
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i had this but did not see they were related i called it acid reflux and take omeprazole 20mg and cpap for my sleep apnea this works .
i had to sleep downstairs for four months with a chronic cough some food made it worse nothing helped i asked everbody
i read things on the internet never in that time GERD came up i just used milk of mag.
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Permalink Reply by amott1973 on
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Hmm, this is really interesting. I've had horrible heartburn and reflux for a long time now, and just take zantac every 12 hours. Even then I can't lie on my right side because I can feel what seems like my stomach dumping into my esophagus. Maybe the zantac isn't enough. I'll have to get that checked out. Thanks for the discussion!
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