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Reflux and Sleep Apnea Connection
Views: 188
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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This is interesting:
http://www.sleepreviewmag.com/sleep_report/2010-04-21_07.asp
Link Between Acid Reflux and Sleep Apnea Challenged
Research published in the April issue of CHEST suggests that a causal link between gastroesophageal reflux (GER) and obstructive sleep apnea (OSA) may not exist.
“Researchers from the Medical College of Wisconsin studied the sleep events of nine patients with GER without OSA, six patients with OSA without GER, 11 patients with OSA and GER, and 15 control subjects,” a CHEST news brief states. “Although GER is thought to be induced by decreasing intraesophageal pressure during OSA, study results showed that esophageal pressures progressively increased during OSA.”
Results from the study showed that the incidence of GER during sleep in patients with OSA and GER did not differ from the remaining three groups. The findings led researchers to speculate that OSA may not induce GER or other reflux events.
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Upper Esophageal Sphincter and Gastroesophageal Junction Pressure Changes Act to Prevent Gastroesophageal and Esophagopharyngeal Reflux During Apneic Episodes in Patients With Obstructive Sleep Apnea
Shiko Kuribayashi, MD, Benson T. Massey, MD, Muhammad Hafeezullah, MBBS, Lilani Perera, MD, Syed Q. Hussaini, MD, Linda Tatro, Ronald J. Darling, MD, Rose Franco, MD, FCCP and Reza Shaker, MD
From the Dysphagia Institute, Division of Gastroenterology and Hepatology (Drs Kuribayashi, Massey, Hafeezullah, Perera, Hussaini, and Shaker, and Ms Tatro), the Department of Otolaryngology (Dr Darling), and the Department of Sleep Medicine (Dr Franco), Medical College of Wisconsin, Milwaukee, WI.
Correspondence to:
Reza Shaker, MD, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226; e-mail: rshaker{at}mcw.edu
Abstract
Background: Gastroesophageal reflux (GER) 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. The aim of this study was to determine UES and GEJ pressure change during OSA and characterize the GER and esophagopharyngeal reflux (EPR) events during sleep.
Methods: We studied 15 controls, nine patients with GER disease (GERD) and without OSA, six patients with OSA and without GERD, and 11 patients with both OSA and GERD for 6 to 8 h postprandially during sleep. We concurrently recorded the following: (1) UES, GEJ, esophageal body (ESO), and gastric pressures by high-resolution manometry; (2) pharyngeal and esophageal reflux events by impedance and pH recordings; and (3) 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.
Results: ESO pressures decreased during OSA events. 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 prevalence of GER and EPR events during sleep in patients with OSA and GERD did not differ from those in controls, patients with GERD and without OSA, and patients with OSA and without GERD.
Conclusions: Despite a decrease in ESO pressure during OSA events, compensatory changes in UES and GEJ pressures prevent reflux.
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Permalink Reply by 99 on
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it is a one way thing
Rock Hinkle said:This is interesting:
http://www.sleepreviewmag.com/sleep_report/2010-04-21_07.asp
Link Between Acid Reflux and Sleep Apnea Challenged
Research published in the April issue of CHEST suggests that a causal link between gastroesophageal reflux (GER) and obstructive sleep apnea (OSA) may not exist.
“Researchers from the Medical College of Wisconsin studied the sleep events of nine patients with GER without OSA, six patients with OSA without GER, 11 patients with OSA and GER, and 15 control subjects,” a CHEST news brief states. “Although GER is thought to be induced by decreasing intraesophageal pressure during OSA, study results showed that esophageal pressures progressively increased during OSA.”
Results from the study showed that the incidence of GER during sleep in patients with OSA and GER did not differ from the remaining three groups. The findings led researchers to speculate that OSA may not induce GER or other reflux events.
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it is a one way thing
like i said about enstine theory it only work one way
so very likely there is no link one way but a definate link the other way
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Permalink Reply by Steven Y. Park, MD on
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It's one contradictory study, but there are many other studies showing that gastric contents can reach the throat. Why would you see pepsin or h. pylori in the nose? Esophageal pressure readings from various studies show severe negative pressures in the thorax and the hypopharnx. The study cited is also a very small study.
Take a look at my blog on Reflux and spontaneous arousals.
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