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Awake apnea associated with gastroesophageal reflux: a specific clinical syndrome

A R Spitzer, J T Boyle, D N Tuchman

    The Journal of Pediatrics
    |February 1, 1984
    PubMed

    Insights

    Awake apnea in infants is often linked to gastroesophageal reflux, causing airway obstruction. While medical management is usually effective, some infants may require surgery for severe cases.

    Area of Science:

    • Pediatric Gastroenterology
    • Neonatology
    • Sleep Medicine

    Background:

    • Infantile awake apnea presents a diagnostic challenge.
    • Gastroesophageal reflux (GER) is a common condition in infants.
    • The relationship between awake apnea and GER requires further investigation.

    Observation:

    • Fifteen infants with awake apnea underwent 24-hour monitoring (esophageal pH, nasal thermistor, impedance pneumography, heart rate).
    • Thirteen of fifteen infants showed airway obstruction associated with GER episodes.
    • Control infants did not exhibit similar findings.

    Findings:

    • All infants with awake apnea had frequent GER episodes.
    • Airway obstruction linked to GER occurred frequently in affected infants.
    • Medical management (monitoring, reflux precautions, urecholine hydrochloride) was successful in 10 of 15 infants.

    Implications:

    • Awake apnea in infants is strongly associated with gastroesophageal reflux.
    • Medical interventions are typically effective for reflux-associated apnea.
    • Surgical intervention (Nissen fundoplication) may be necessary for refractory cases or severe esophagitis.

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