Clinical course and cardio-respiratory monitoring of patients with obstructive sleep apnea and gastroesophageal reflux disease

Abstract

Purpose. To study the obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) combined course characteristics based on clinical studies and cardio-respiratory monitoring.Materials and methods. 125 patients were examined: group I – 31 patients with GERD, group II – 32 patients with OSA, group III – 62 patients with combined OSA and GERD. A cardio-respiratory study, esophagogastroduodenoscopy were performed. The severity of complaints was assessed on the Likert scale, GERD symptoms evaluation – on the F.S.S.G. Patients were questioned on a scale of reactive (RA) and personal (PA) anxiety by Spielberger–Khanin scale. Patients were tested for H. pylori infection by the stool-test.Results. Patients of group III, compared with patients of group I, showed a significant increase in complaints of reflux feeling (+64.4 %), cough (+41.3 %), heartbeat and feeling of interruptions in the heart (+71.6 %), dysphagia (+16.3 %) (P < 0.05). In group III, the magnitude of the component “reflux symptoms” according to F.S.S.G. was byn 1.5 times, and the component “symptoms of dysphagia” was by 1.7 times more than in group I (P < 0.05). In group III, moderate and severe degree of apnea was observed in patients (71 %), while in group II there were 17 patients (53 %). In patients of group ІІІ, the value of the PA indicator exceeded the analogous parameter in patients of group І by +35.7 % (P < 0.05), Group II – by +80.9 % (P < 0.05). Patients of group III had more severe course of GERD (according to endoscopic signs) (χ2 = 5.125, df = 2, P < 0.05). A significant interaction was determined between the degree of esophagus damage and H. pylori infection, the severity of OSA (respectively, γ = +0.46 and γ = +0.30, P < 0.05). Significant relationships were found between the severity of OSA and the severity of GERD symptoms, the duration of GERD, and H. pylori infection.Conclusions. Patients with a combined course of OSA and GERD have a mutual burdening syndrome, which worsens the course of two diseases.