title: Symptomatic gastro-oesophageal reflux, arousals and sleep quality in patients undergoing polysomnography for possible obstructive sleep apnoea.
abstract: BACKGROUND
  Nocturnal acid reflux is common and could disturb sleep by causing arousals that fragment sleep.
  
  
  OBJECTIVE
  To determine the prevalence of gastro-oesophageal reflux symptoms and their association with arousals, stages of sleep and quality of life in patients undergoing evaluation for excessive daytime sleepiness and obstructive sleep apnoea.
  
  
  METHODS
  Ninety-four consecutive patients with excessive daytime sleepiness were prospectively studied. Patients completed the gastrointestinal symptom rating scale, a validated symptom questionnaire for reflux disease and a disease-specific quality of life questionnaire, the sleep apnoea quality of life index and then underwent overnight polysomnography, which was read in a blinded manner.
  
  
  RESULTS
  There were 40 males and 54 females with a mean age of 47 +/- 13 years. Reflux symptoms were present in 63 of the 94 (67%) patients. Patients with reflux symptoms had significantly more arousals from sleep 43 +/- 70/h than those without (20 +/- 24/h; P = 0.03). The sleep duration during the second stage of sleep was shorter (44 +/- 21%) for those with reflux symptoms than those without (52 +/- 12%; P = 0.03). Patients with reflux spent significantly shorter periods in stage II sleep (44 +/- 21%) than those without (52 +/- 12%; P = 0.03). The sleep-related quality of life score in patients with gastro-oesophageal reflux (3.1 +/- 1.1) was significantly lower than in patients without reflux (3.7 +/- 1.0; P = 0.02). Regression analysis demonstrated a significant inverse correlation between quality of life and reflux symptom score (P =0.002) and total spontaneous arousals (P = 0.04).
  
  
  CONCLUSIONS
  Gastro-oesophageal reflux is common in patients with sleep disorders, is associated with increased arousal, decreased durations spent in the deeper stages of sleep and poorer sleep-related quality of life.
authors.affiliation: University of Wisconsin Medical School, Aurora Sinai Medical Center, Milwaukee, WI 53233, USA.
authors.forename: N
authors.initials: N
authors.lastname: Guda
authors.forename: S
authors.initials: S
authors.lastname: Partington
authors.forename: N
authors.initials: N
authors.lastname: Vakil
mesh_terms: D001143:Arousal / Q000502:physiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology*; D012894:Sleep Stages / Q000502:physiology*; D011795:Surveys and Questionnaires