Oztürk Ozcan, Oztürk Levent, Ozdogan Ahmet, Oktem Fatih, Pelin Zerrin
Department of Otorhinolaryngology and Head and NeckSurgery, Abant Izzet Baysal University, Düzce Faculty of Medicine, Düzce, Turkey.
Eur Arch Otorhinolaryngol. 2004 Apr;261(4):229-32. doi: 10.1007/s00405-003-0658-z. Epub 2003 Aug 12.
A number of recent studies have suggested that apnea and/or hypopnea episodes may be in a causal relationship with nocturnal gastroesophageal reflux (GER) episodes in obstructive sleep apnea (OSA) patients. In this study, we addressed the possible factors that may affect the occurrence of reflux events in OSA patients. For this reason, we investigated respiratory and sleep parameters in OSA patients with or without nocturnal GER episodes. Nineteen patients who were referred to the sleep laboratory for suspected sleep apnea were included in the study. All subjects underwent polysomnographic evaluation simultaneously with distal and proximal esophageal pH monitoring. During the recording period, a total of 134 reflux events, 134 from distal probes and none from proximal probes, were recorded. We divided patients into two groups: (1) nocturnal GER-positive patients ( n=8; age: 41.9+/-11.9) and (2) nocturnal GER-negative patients ( n=11; age: 45.4+/-3.3). We compared demographic, respiratory and sleep parameters between the two groups. Then we analysed the time relation between GER episodes and obstructive respiratory events. The two groups were matched by age and body mass index. Sleep and respiratory parameters were not different between the two groups. In conclusion, we suggested that age, body mass index and the severity of disease in obstructive sleep apnea patients are not effective determinants of gastroesophageal reflux. There is no sufficient evidence to accept arousals and obstructive apneas as primary causes of gastroesophageal reflux and vice versa. And finally, sleep macroorganisation has no impact on the occurrence of GER in OSAS.
最近的一些研究表明，在阻塞性睡眠呼吸暂停（OSA）患者中，呼吸暂停和/或呼吸浅慢发作可能与夜间胃食管反流（GER）发作存在因果关系。在本研究中，我们探讨了可能影响OSA患者反流事件发生的因素。因此，我们调查了有或无夜间GER发作的OSA患者的呼吸和睡眠参数。19名因疑似睡眠呼吸暂停被转诊至睡眠实验室的患者纳入了本研究。所有受试者同时接受多导睡眠图评估以及食管远端和近端pH监测。在记录期间，共记录到134次反流事件，其中134次来自远端探头，近端探头未记录到反流事件。我们将患者分为两组：（1）夜间GER阳性患者（n = 8；年龄：41.9±11.9）和（2）夜间GER阴性患者（n = 11；年龄：45.4±3.3）。我们比较了两组之间的人口统计学、呼吸和睡眠参数。然后我们分析了GER发作与阻塞性呼吸事件之间的时间关系。两组在年龄和体重指数方面相匹配。两组之间的睡眠和呼吸参数没有差异。总之，我们认为阻塞性睡眠呼吸暂停患者的年龄、体重指数和疾病严重程度不是胃食管反流的有效决定因素。没有足够的证据认为觉醒和阻塞性呼吸暂停是胃食管反流的主要原因，反之亦然。最后，睡眠宏观结构对阻塞性睡眠呼吸暂停综合征患者GER的发生没有影响。
