The relationship between gastroesophageal reflux and apnea in infants.
OBJECTIVE
To determine the prevalence and relationship between apnea and gastroesophageal reflux (GER) among infants with apparent life-threatening events.


METHODS
We evaluated 67 infants of ages up to 6 months who had an idiopathic apparent life-threatening event as determined by polysomnography and pH monitoring.


RESULTS
No reflux (pH < 4 for more than 6 seconds) was evident in 32 infants. Fourteen others had such prolonged reflux that the relationship between apnea and reflux could not be evaluated. The 21 remaining infants who had episodes of apnea and reflux constituted the study group. In 81% of the apneic episodes, no relationship to GER was noted. Apnea preceded reflux in 93.6% of the episodes, and only 6.4% of the apneic episodes followed reflux. When apnea preceded reflux, the apnea was obstructive in 66.8% of episodes and mixed in 33.2%. Central apnea was not recorded preceding reflux.


CONCLUSIONS
Episodes of apnea were seldom associated with GER. However, in those instances when apnea and reflux were associated, the predominant sequence of events was obstructive apnea and to a lesser extent mixed apnea followed by reflux.
Arad-Cohen
N
N
Jacobo Lichtman Apnea Investigation Unit, Department of Pediatrics, Bnai Zion Medical Center, Technion, Israel.
Cohen
A
A
Tirosh
E
E
D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008297:Male; D017286:Polysomnography; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications*; D020182:Sleep Apnea, Central / Q000150:complications; D020181:Sleep Apnea, Obstructive / Q000150:complications; D018709:Statistics, Nonparametric; D013997:Time Factors