Gastroesophageal reflux and obstructive sleep apnea: more dangers in the night.

摘要

Gastroesophageal reflux (GER) is a common event which occurs predominately post prandially and results in clinical complaints primarily of heartburn and regurgitation. In addition, GER has been noted to be a frequent occurrence in patients with obstructive sleep apnea (OSA) [1]. It has also been established that the proximal migration of minute amounts of acid is facilitated by sleep [2]. These findings would seem to beg the question of frequency and consequences of laryngopharyngeal reflux (LPR) in patients with OSA, especially since LPR would predispose to the potentially very dangerous consequence of pulmonary aspiration. In this issue of Sleep Medicine, Suzuki and colleagues [3] have addressed this issue. They have shown that in patients with severe OSA reflux events (both LPR and GER) are more frequently associated with respiratory arousals and that subjects with mild/moderate OSA, surprisingly, have more spontaneous arousals with LPR events. These are most interesting preliminary observations which need to be confirmed by future research.