Prevalence of symptomatic gastroesophageal reflux disease (GERD) in severe obstructive sleep apnea (OSA)

Abstract

The pathogenetic relationship underlying the high prevalence of gastroesophageal reflux disease (GERD) in patients with obstructive sleep apnea (OSA) remains unclear. Objective: 1.To investigate the GER in patients with severe OSA and to corroborate variations in the pH-metry register using auto-CPAP. 2.To test symptoms of GERD at baseline and after beginning treatment for OSA. METHOD: Prospective study with 22 severe OSA patients to study GERD by endoscopic placement of a record of continuous wireless pH monitoring(BravoTM capsule, up to 96 hours recording). After placing the capsule, nocturnal polysomnography study was done and then the auto-CPAP treatment began. Symptoms of GERD were assessed using specific questionnaires (GSRS and QOLARD),filled prior to placement of the capsule, at 96 hours and at a month. RESULTS: 77.2 % were man and obese (63.6%). The incidence of GERD was 65%. After starting auto-CPAP, we observed a significant improvement of parameters associated with the GER in 48 hours, with normalization of pH monitoring in 61.5 % of cases, although without reaching statistical significance. Significant symptomatic changes in the score of the questionnaires at baseline, at 96 hours and at a month after initiation of treatment with auto-CPAP were found. There were with a baseline score for GSRS>2.5 in 40.9% of cases and with the QOLARD CONCLUSIONS: We found a high prevalence of symptomatic GERD in patients with severe OSA. There are significant improvement in symptoms of GERD and tendency to normalization of pathological GER after initiation of treatment with CPAP. These findings could justify the active pursuit of GERD in patients with severe OSA.