title: Gastroesophageal reflux and obstructive sleep apnea in childhood.
abstract: OBJECTIVE
  To examine the relationship between gastroesophageal reflux (GER) and obstructive sleep apnea syndrome (OSAS) with polysomnographic alterations and symptom severity.
  
  
  METHODS
  Eighteen children aged from 6 to 12 years (8.14+/-1.75) with adenotonsillar hypertrophy and OSAS were evaluated with the OSA-18 questionnaire nasofibrolaringoscopy and full overnight polysomnography performed simultaneously with esophageal pH monitoring.
  
  
  RESULTS
  OSAS (Apnea-index (AI)>or=1/hour) was present in all cases. Reflux parameters did not correlate to OSAS severity and a temporal relationship between GER and apnea-hypopnea events was not observed. Body mass index was lower than 18 in 9 cases (52.9%) and 7 children (41.1%) presented a history of abnormal behavior during sleep. In most cases oxygen desaturation and reduction of sleep efficiency were mild. Sleep architecture was similar to the young adult pattern. Seven children (41.1%) presented pH monitoring values below 4 during more than 10% of total sleep time. pH monitoring values were correlated to emotional distress (p=0.008) and to daytime problems (p=0.03) as evaluated by the OSA-18.
  
  
  CONCLUSIONS
  GER is frequent and should be assessed in children from 6 to 12 years with OSAS. Emotional distress and daytime problems are correlated to increased GER severity.
authors.affiliation: Department of Medicine, Federal University of Ceará, Brazil.
authors.forename: Alessandra Caland
authors.initials: AC
authors.lastname: Noronha
authors.forename: Veralice Meireles Sales
authors.initials: VM
authors.lastname: de Bruin
authors.forename: Miguel Angelo
authors.initials: MA
authors.lastname: Nobre e Souza
authors.forename: Marcos Rabelo
authors.initials: MR
authors.lastname: de Freitas
authors.forename: Roberta de Paula
authors.initials: Rde P
authors.lastname: Araújo
authors.forename: Rosa Maria Salani
authors.initials: RM
authors.lastname: Mota
authors.forename: Pedro Felipe Carvalhedo
authors.initials: PF
authors.lastname: de Bruin
mesh_terms: D000234:Adenoids / Q000473:pathology; D002648:Child; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006984:Hypertrophy; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000473:pathology