T1916 Relationship Between Symptomatic Gastroesophageal Reflux, Sleep Parameters, Daytime Sleepiness and Sleep Quality in Patients With Obstructive Sleep Apnea

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Background Previous studies have shown that patients with globus demonstrate visceral hypersensitivity in distal esophagus. In response to mechanical distension of the distal esophagus, globus patients tend to attribute the perception or pain sensation to the region at or above the suprasternal notch (Chen 09).Our aim was to evaluate upper esophageal sphincter (UES) and esophageal body tone and sensitivity in healthy volunteers and patients with globus. Patients and methods : 9 patients ( 6M, mean age 59 yrs) with globus and 10 healthy controls (5 M, mean age 27 yrs) underwent an esophageal body and UES barostat study. Esophageal and UES visceral perception (tone and sensitivity) were assessed by esophageal balloon distension using stepwise isobaric distensions (2mmHg) with the balloon located 10 cm below the UES and in the high pressure zone of the UES. UES and esophageal perception and discomfort thresholds were determined (mean±SEM) and compared (T test). Results : In the UES, patients reported their first sensation at balloon mean volume of 0.2±0.15 ml whereas controls reported their first sensation at mean volume of 1.2±0.47 ml (p= 0.03). Patients reported discomfort at mean balloon volume of 9.7±0.47 ml which was similar to controls (11.9±1.77 ml, p=0.23). In the esophageal body, patients and controls first sensation and discomfort occurred at similar mean balloon volumes (respectively 7.15±2.92 vs. 4.9±1.05ml, p= 0.25 and 19.2±3.3 vs.19.1± 2.8 ml, p= 0.49). In both, globus patients and controls, the esophageal body was less compliant compared to the UES ((1.6±0.2 vs 1.1±0.06 ml/mmHg(p=0.007); (1.5±0.1 vs 1.0±0.07 ml/mmHg (p=0.0001)). However, the compliance in the UES did not differ between globus patients and controls (p=0.8 ; p= 0.3). Conclusion : The UES of globus patients is equally complaint but more sensitive to distention compared to healthy controls. The visceral sensitivity of the esophageal body did not differ between both groups.