Arousals in obstructive sleep apnea patients with laryngopharyngeal and gastroesophageal reflux.
OBJECTIVE
We hypothesized that differences exist in the effect of apnea severity and those of laryngopharyngeal reflex (LPR) versus gastroesophageal reflex (GER) on arousals during sleep in patients with obstructive sleep apnea syndrome (OSAS).


METHODS
Japanese patients having witnessed snoring or excessive daytime sleepiness with a frequency scale for symptoms of GER of 10 or more or with visualization of inflammatory changes on pharyngolaryngeal endoscopy underwent polysomnography with pH monitoring using double pH catheter in a sleep laboratory.


RESULTS
Most reflux events in patients with severe OSAS with LPR (n=16) and GER (n=21) were accompanied with respiratory arousals. On the other hand, among patients with mild-to-moderate OSAS, 64.0% and 24.8% of reflux events were accompanied with spontaneous arousals in those with LPR (n=12) and GER (n=12), respectively, and 9.4% and 8.3% of reflux events were not accompanied by arousals. There were no significant differences in other sleep parameters between mild-to-moderate OSAS patients with LPR versus GER and between severe OSAS patients with LPR versus GER.


CONCLUSIONS
Among patients with reflux, the types of arousal differed significantly between those with mild-to-moderate versus severe OSAS. In patients with mild-to-moderate OSAS, LPR induces more spontaneous arousals than does GER.
Department of Otolaryngology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan. suzukima@med.teikyo-u.ac.jp
Masaaki
M
Suzuki
Hanako
H
Saigusa
Ryoko
R
Kurogi
Takatsugu
T
Yamamoto
Toshihiko
T
Ishiguro
Takayuki
T
Yohsizawa
Yasushi
Y
Kuyama
Taiji
T
Furukawa
D000328:Adult; D001143:Arousal / Q000502:physiology*; D015897:Comorbidity; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology