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Permalink Reply by The SleepGuide Crew on February 5, 2009 at 11:02pm

That's great info. I have to get Dr. Park's book --- sounds like a truly informative one. You might want to try sleeping on a wedge which will elevate the top portion of your body so that the acid stays down in your stomach where it belongs. does dr. park recommend such a thing in his book?

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Permalink Reply by Steven Y. Park, MD on February 6, 2009 at 6:37am

There are a lot of different explanations for laryngopharyngeal reflux disease, but one thing's for sure is that LPRD is very different from GERD. LPRD patients have more of a problem when upright, and is thought to be a physiologic problem with the upper esophageal sphincter. GERD is the reverse (nighttime reflux and a problem with the lower eophageal sphincter). But apneas have been found to relax the lower esophageal sphincter as well.

There is definitely an overlap of signs and symptoms between the two. Another major reason for stomach juices reaching the throat is due to the severe vacuum pressures that are created during any degree of obstruction or apnea (one second or 30 seconds). Even in mild cases of what's called inspiratory flow limitation, intrathoracic pressures drop. This suctions up normal stomach contents into the throat, leading to the classic findings of LPRD. You also have to realize that it's not only acid, but bile digestive enzymes and bacteria that come up, and as Henning mentioned, this has been shown to reach even the ear, sinuses and lungs!

Although we generally prescribe the same conservative recommendations for LPRD as GERD, it's generally thought that elevating the head is not as effective due to the active suctioning effect (although it does help in some people).

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Permalink Reply by Henning on February 6, 2009 at 10:48am

I was not aware that I had any kind of reflux; for a couple of weeks, I just felt I was a little rough in the throat. I have not had Reflux for years (as far as I know).

It gave me something to think about because I have not used my CPAP for a while. I await a new sleep study after a nose surgery.

But apparently I still have some kind of SA; I think especially when I sleep on my back.

I have today received an oral appliance. This is an over-the-counter "boil-and-bite" model, just to try if it works for me.

I am curious how this works. I will try it tonight.

BTW.
I think the best advice about reflux is not to eat and drink alcohol the last 3 hours before bedtime. (This is also a good advice from Dr. Parks’s book).

Henning

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Permalink Reply by royalty on February 6, 2009 at 4:02pm

this is true I also had major problems before my treatment so bad that my throat was erroded .i couldn't keep food down for a month. since treament and being on my cpap machine it has pretty much gone away although I have to watch what i eat at a certain amount if time before i go to bed. i tell you one cheap way to get rid of it is take a teaspoon of baking soda with 8 ounces of water. gets rid of it instantly. one problem is that you will have gas for about a minute. not much more than drinking a soda.

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Permalink Reply by Henning on February 14, 2009 at 5:22pm

It is amazing.

I dropped out of the medicine (ESOPRAL) after one day, due to large side events.

However, as mentioned, I started with my (temporary) oral appliance. Now a week after my Acid reflux are totally disappeared.

Of course, it could disappear by itself, but I am quite convinced that it was because of my treatment with my oral appliance.

Henning

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Permalink Reply by Mary Z on February 7, 2012 at 11:32am

bump

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