[Correlations between gastroesophageal reflux disease and obstructive sleep apnea]

Several studies have reported an increased prevalence of gastroesophageal reflux disease in patients with obstructive sleep apnea. The increasingly negative intrathoracic and transdiaphragmatic pressure should facilitate of reflux-events during apnea.

The aim of the present study was to investigate whether there exists a link between endoscopic severity of reflux disease and the parameters of obstructive sleep apnea and the typical symptoms of reflux disease.

57 patients with proven obstructive sleep apnea were divided into two groups according to the severity of the sleep apnea: "mild-moderate"--apnea-hypopnea index > or = 5-30, n = 27, "severe"--apnea-hypopnea index > 30, n = 30. All patients underwent upper panendoscopy, apnea monitoring during the night and were asked about existing and frequency of typical reflux symptoms.

All examined patients in both groups showed significant overweight and there was a positive correlation between body mass index and the degree of sleep apnea (p = 0.0002). The occurrence of erosive reflux disease was significantly higher in "severe" group (p = 0.0001). Using a logistic regression analysis a positive correlation was found between endoscopic severity of reflux disease and apnea-hypopnea index (p = 0.016). 49.5% of all patients experienced the typical symptoms of reflux disease at least three times a week and there was not significant difference between groups.

The study reveals that in patients with severe obstructive sleep apnea, erosive reflux disease is more frequent and a positive correlation can be found between severity of reflux disease and sleep apnea as well.