Abstract
Objectives:
We test the hypothesis that treatment of gastroesophageal reflux disease (GERD) can improve obstructive sleep apnea-hypopnea syndrome (OSAHS).
Methods:
One hundred forty-six patients with OSAHS underwent a complete history-taking, physical examination, and laboratory testing, including questions related to GERD symptoms. Full-night attended polysomnography, 24-hour wireless pH study at the upper esophagus, snoring level evaluation, Epworth Sleepiness Scale, and quality-of-life surveys were completed for each patient. Patients who tested positive for GERD were treated with esomeprazole magnesium 40 mg once daily for 2 to 12 months. The 24-hour pH study was repeated, and those patients with elimination of GERD were reevaluated by polysomnography, snoring level evaluation, Epworth Sleepiness Scale, quality-of-life surveys, and subjective data collection.
Results:
Forty-one patients completed single-dose treatment with esomeprazole, but the repeat 24-hour pH study showed that 9 patients had persistent GERD. In the 29 patients who completed phase 2 with normal pH study findings, the snoring level decreased from 9.7 ± 0.5 to 7.9 ± 1.3 (p < .0001), the Epworth Sleepiness Scale score decreased from 14.2 ± 2.5 to 11.1 ± 2.4 (p < .0001), the apnea-hypopnea index decreased from 37.9 ± 19.1 to 28.8 ± 11.5 (p = .006), and the minimum saturation of oxygen increased from 84.1% ± 7.8% to 86.9% ± 5.0% (p = .055).
Conclusions:
Treatment of GERD had a significant impact on the reduction of the apnea-hypopnea index, snoring, and daytime sleepiness. Elimination of GERD should be part of a comprehensive treatment plan for patients with OSAHS.
Keywords
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