Relationship Between Laryngopharyngeal Reflux and Obstructive Sleep Apnea in Adult Males

To investigate the relationship between laryngopharyngeal reflux (LPR) and obstructive sleep apnea (OSA).

Patients diagnosed with OSA who were hospitalized in the Department of Otolaryngology-Head and Neck Surgery from November 2021 to April 2022 were selected, and male patients with non-OSA during the same period were selected as the control group. Patients who participated in the study completed the Reflux Symptom Index (RSI), the Reflux Finding Sign (RFS), and 24-hour multichannel intraluminal impedance-pH (MII-pH) monitoring. RSI, RFS, and outcomes of 24 hour-MII-pH monitoring were compared between the OSA group and the control group.

A total of 86 patients were enrolled, of whom 49 were OSA patients and 37 were non-OSA patients. The positive rate of LPR (97.96% vs 75.68%) and the median number of LPR episodes (9 vs 5) were significantly higher in OSA patients than in non-OSA patients (P < 0.01, P < 0.05, respectively). A logistic regression model including body mass index, alcohol consumption, and the presence of OSA showed that having OSA was a risk factor for the occurrence of LPR (P < 0.05, OR [odds ratio] = 9.995, 95% CI [confidence interval] 1.084-92.181). There were correlations between Apnea-Hypopnea Index and the number of non-acid LPR episodes and the number of alkaline LPR episodes (r = 0.243, P < 0.05, r = 0.274, P < 0.05, respectively).

Having OSA is a risk factor for LPR, and LPR episodes occur more frequently in patients with OSA compared to those without OSA. When OSA is comorbid with LPR, the occurrence of alkaline LPR, such as bile reflux, should be a concurrent concern.