Arunthari V, Waller EA, Fredrickson PA, et al. Mayo Foundation for Medical Education and Research, 2010.
OBJECTIVES: Nocturnal gastroesophageal reflux disease (GERD) resulting in extraesophageal reflux (EER) may contribute to airway inflammation and worsen obstructive sleep apnea (OSA). Conversely, OSA may aggravate nocturnal EER. We hypothesize that patients with OSA and GERD are at an increased risk for nocturnal EER and that continuous positive airway pressure (CPAP) will lead to its reduction.
RESULTS: 8 subjects were enrolled. All were confirmed to have OSA with a median apnea hypopnea index (AHI) of 54, improving to 6 on CPAP (p=0.008). The severity of EER at baseline was variable with a median reflux rate of 6 (IQR 3.5– 23). We observed a non-significant reduction in the EER rate following CPAP (median: 0.8 vs. 0.4 events/hour, p=0.22) in the overall comparison. However, when accounting for the severity of the underlying EER, a statistically significant reduction in EER following CPAP was observed for those with more severe EER at baseline (Tau=0.71, p=0.013).
CONCLUSION: CPAP may be effective in improving moderate to severe nocturnal EER. Its efficacy however is dependent on the severity of the underlying EER. Further prospective study is in need.