Laryngopharyngeal reflux and primary snoring: a pilot case-control study

Laryngopharyngeal reflux has been implicated as a causative factor in the aetiology of sleep related breathing disorders. However there are no reports on the association of this disorder and primary snoring in the absence of obstructive sleep apnoea. This study was undertaken to investigate any link between primary snoring and the presence of laryngopharyngeal reflux.

A matched case-control study was performed in a district general Ear Nose Throat outpatient population in the United Kingdom. Twenty six patients referred for snoring without sleep apnoea (cases) were individually matched for gender, body mass index and age, to 26 patients referred for other otorhinolaryngological complaints (controls). Snoring was not an exclusion criterion for the controls. Exclusion criteria for both groups were previous referral or treatment for snoring and/or sleep apnoea, nasal obstruction symptoms (as a potential cause of snoring), and known history of gastrooesophageal reflux with medical treatment longer than two months. The main outcome measure was prevalence of laryngopharyngeal reflux based on the Reflux Symptom Index score.

Patients seeking medical advice for primary snoring are fourteen times more likely to report Reflux Symptom Index scores of more than 13 than controls.

Laryngopharyngeal reflux may also be implicated in the pathogenesis of primary snoring in the absence of sleep apnoea. This constitutes 3b level of evidence.