Maroun Tawk1, Suanne Goodrich, Gary Kinasewitz, William Orr. 1. Pulmonary and Critical Care Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd, WP 1310, Oklahoma City, OK 73104, USA. Maroun-tawk@ouhsc.edu
Abstract
STUDY OBJECTIVES: Patients with obstructive sleep apnea (OSA) have a very high incidence of gastroesophageal reflux (GER). Previous studies have shown that the use of continuous positive airway pressure (CPAP) reduces the frequency of reflux events, but these studies only assessed the effect of a single night of treatment. The aim of this study was to assess the effect of 1 week of CPAP treatment on reflux in patients with OSA and GER. DESIGN: Sixteen patients with OSA and GER were recruited. Polysomnography followed by 24-h, continuous esophageal pH monitoring were performed at baseline. Patients with an apnea-hypopnea index (AHI) > 20/h and 24-h acid contact time (ACT) of at least 6% were included. As part of the polysomnography-qualifying evaluation, all patients underwent CPAP titration to reduce the AHI to < 10/h. Patients were then sent home receiving nasal CPAP for 1 week; after 1 week, esophageal pH monitoring was repeated while receiving CPAP. MEASUREMENTS AND RESULTS: The AHI fell from 63.3 +/- 38.5 to 3.2 +/- 2.2/h (mean +/- SD) [p < 0.001]. Total ACT fell from 13.9 +/- 11.6 to 5.6 +/- 2.7% (p < 0.001). The upright ACT was reduced from 12.4 +/- 6.8 to 6.8 +/- 3.8% (p = 0.01), and the supine (during the sleeping interval) ACT was reduced from 16.3 +/- 18.8 to 3.8 +/- 7.6% (p < 0.01). Eighty-one percent of the patients had a reduction in supine ACT to within the normal range (< 4%). CONCLUSIONS: In OSA patients with significant heartburn complaints, CPAP would appear to be an efficacious approach to the treatment of both disorders.
STUDY OBJECTIVES:Patients with obstructive sleep apnea (OSA) have a very high incidence of gastroesophageal reflux (GER). Previous studies have shown that the use of continuous positive airway pressure (CPAP) reduces the frequency of reflux events, but these studies only assessed the effect of a single night of treatment. The aim of this study was to assess the effect of 1 week of CPAP treatment on reflux in patients with OSA and GER. DESIGN: Sixteen patients with OSA and GER were recruited. Polysomnography followed by 24-h, continuous esophageal pH monitoring were performed at baseline. Patients with an apnea-hypopnea index (AHI) > 20/h and 24-h acid contact time (ACT) of at least 6% were included. As part of the polysomnography-qualifying evaluation, all patients underwent CPAP titration to reduce the AHI to < 10/h. Patients were then sent home receiving nasal CPAP for 1 week; after 1 week, esophageal pH monitoring was repeated while receiving CPAP. MEASUREMENTS AND RESULTS: The AHI fell from 63.3 +/- 38.5 to 3.2 +/- 2.2/h (mean +/- SD) [p < 0.001]. Total ACT fell from 13.9 +/- 11.6 to 5.6 +/- 2.7% (p < 0.001). The upright ACT was reduced from 12.4 +/- 6.8 to 6.8 +/- 3.8% (p = 0.01), and the supine (during the sleeping interval) ACT was reduced from 16.3 +/- 18.8 to 3.8 +/- 7.6% (p < 0.01). Eighty-one percent of the patients had a reduction in supine ACT to within the normal range (< 4%). CONCLUSIONS: In OSA patients with significant heartburn complaints, CPAP would appear to be an efficacious approach to the treatment of both disorders.
Authors: Toby N Weingarten; Michael L Kendrick; James M Swain; Lavonne M Liedl; Christopher P Johnson; Darrell R Schroeder; Bruce D Johnson; Juraj Sprung Journal: Obes Surg Date: 2011-12 Impact factor: 4.129
Authors: A Eryılmaz; L Erişen; U L Demir; F Kasapoglu; O A Ozmen; A Ursavas; M Kıyıcı; I Hızalan Journal: Eur Arch Otorhinolaryngol Date: 2012-06-17 Impact factor: 2.503
Authors: William C Orr; Jennifer J T Robert; John R Houck; Cheryl L Giddens; Maroun M Tawk Journal: J Clin Sleep Med Date: 2009-08-15 Impact factor: 4.062