Charaklias N, Mamais C, Pothula V, Kumar B N
Otolaryngology Department, Wrightington Wigan and Leigh NHS Trust, Wigan WN1 2NN, United Kingdom.
B-ENT. 2013;9(2):89-93.
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.
喉咽反流被认为是睡眠相关呼吸障碍病因中的一个致病因素。然而，在无阻塞性睡眠呼吸暂停的情况下，关于这种疾病与原发性打鼾之间的关联尚无报道。本研究旨在调查原发性打鼾与喉咽反流之间的任何联系。
在英国一家地区综合耳鼻喉科门诊人群中进行了一项匹配病例对照研究。将26例因打鼾但无睡眠呼吸暂停前来就诊的患者（病例组），根据性别、体重指数和年龄，与26例因其他耳鼻喉科疾病前来就诊的患者（对照组）进行个体匹配。打鼾并非对照组的排除标准。两组的排除标准均为既往因打鼾和/或睡眠呼吸暂停接受过转诊或治疗、鼻塞症状（作为打鼾的潜在原因）以及已知有胃食管反流病史且接受药物治疗超过两个月。主要观察指标是基于反流症状指数评分的喉咽反流患病率。
因原发性打鼾寻求医疗建议的患者报告反流症状指数评分超过13的可能性是对照组的14倍。
在无睡眠呼吸暂停的情况下，喉咽反流可能也与原发性打鼾的发病机制有关。这构成了证据等级3b。
