title: Effect of proton pump inhibitor (PPI) treatment in obstructive sleep apnea syndrome: an esophageal impedance-pHmetry study.
abstract: OBJECTIVE
  There is an increasing interest for a link between gastroesophageal reflux (GER) and obstructive sleep apnea syndrome (OSAS). There is no study in the literature which examines the relationship between OSAS and esophageal functions in adults with impedance. We first evaluated the role of reflux in OSAS with simultaneous polysomnography and impedance-pHmetry and then investigated whether the effect of proton pump inhibitor (PPI) treatment changes in these parameters.
  
  
  METHODS
  Twenty two OSAS patients who had applied to sleep laboratory between September 2007 and May 2008 were consecutively enrolled to the study. Twenty four hours esophageal impedance study was performed during polysomnographic recording. At least 50% of all apneas in patients must proceed with a reflux event in 2 minute intervals in order to be considered reflux related apnea patient.
  
  
  RESULTS
  Pathologic reflux episodes were determined in 20 patients (8 were weakly acidic, 12 were acidic). Reflux dependent apnea was found in 6 patients. There was endoscopically esophagitis in all reflux related apnea patients. There was a negative correlation between initial mean SaO2 and gas reflux events at night (p=0.004, r =-0.588) and mixed reflux events at night (p=0.02, r=0.493). There was a statistically significant regression of AHI (apnea hypopnea index) after 3-months PPI treatment (p=0.012).
  
  
  CONCLUSIONS
  Reflux may trigger apnea in some of the OSAS patients. Therefore, each OSAS patient must be inquired about esophageal and extraesophageal symptoms of reflux.
authors.affiliation: Department of Gastroenterology, Istanbul University, Istanbul, Turkey. fatihermis2@hotmail.com
authors.forename: Fatih
authors.initials: F
authors.lastname: Ermis
authors.forename: Filiz
authors.initials: F
authors.lastname: Akyuz
authors.forename: Serpil
authors.initials: S
authors.lastname: Arici
authors.forename: Ahmet
authors.initials: A
authors.lastname: Uyanikoglu
authors.forename: Fatih
authors.initials: F
authors.lastname: Yakar
authors.forename: Binnur
authors.initials: B
authors.lastname: Pinarbasi
authors.forename: Kadir
authors.initials: K
authors.lastname: Demir
authors.forename: Sadakat
authors.initials: S
authors.lastname: Ozdil
authors.forename: Fatih
authors.initials: F
authors.lastname: Besisik
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Kaymakoglu
authors.forename: Gungor
authors.initials: G
authors.lastname: Boztas
authors.forename: Caglar
authors.initials: C
authors.lastname: Cuhadaroglu
authors.forename: Zeynel
authors.initials: Z
authors.lastname: Mungan
mesh_terms: D050782:Esophageal pH Monitoring; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors