Chest
Original ResearchThe Effect of 1 Week of Continuous Positive Airway Pressure Treatment in Obstructive Sleep Apnea Patients With Concomitant Gastroesophageal Reflux
Section snippets
Subjects
The protocol was reviewed and approved by the Institutional Review Board at The University of Oklahoma Health Sciences Center. Appropriate informed consent was obtained from all patients. Patients were identified as likely to have sleep apnea based on clinical criteria including loud snoring, interrupted sleep at night, and excessive daytime sleepiness. Patients were required to have symptoms of reflux for at least 4 days a week, and awakening from sleep with heartburn at least once a week. The
Results
Forty-three patients were screened, and 16 patients (14 men and 2 women) were enrolled in the study. The others were excluded either because of AHI < 20/h (n = 13) or because of 24-h ACT < 6% (n = 11). Two patients were excluded because of very severe sleep apnea associated with significant oxygen desaturation that required supplemental oxygen during the night. The average use of CPAP was 5.9 ± 1.7/h per night. The mean body mass index (BMI) was 35.1 ± 6.6 kg/m2 (Table 1).
Discussion
To our knowledge, this is the first study that has examined the effect of CPAP on GER in patients with sleep apnea beyond 1 single night of therapy. We found a significant reduction in the total 24-h acid contact. This was more impressive in the supine position when the patient was receiving CPAP. To our surprise, this beneficial effect was maintained to a certain extent during the day when the patient was awake and not receiving CPAP.
The coexistence of OSA and GER is common in the obese
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2020, Sleep MedicineCitation Excerpt :As an effective and noninvasive treatment for OSA, the mechanism of CPAP is to maintain a certain positive pressure in the upper airway. It has been confirmed that CPAP can completely or partially eliminate the occurrence of GER at night through increasing of esophageal internal pressure rather than reduction of apnea or micro arousal [7,23]. It has been speculated that CPAP may also cause reflex contraction of LES, so as to achieve anti-reflow effect [24].
The authors have no conflicts of interest to disclose.
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