title: Obstructive sleep apnea is a risk factor for Barrett's esophagus.
abstract: OBJECTIVE
  Common risk factors for obstructive sleep apnea (OSA) and Barrett's esophagus (BE) include obesity and gastroesophageal reflux disease (GERD). The aims of this study were to assess the association between OSA and BE and to determine whether the association is independent of GERD and body mass index (BMI).
  
  
  METHODS
  Patients who had undergone a diagnostic polysomnogram and esophagogastroduodenoscopy were identified by using Mayo Clinic (Rochester, Minnesota) databases from January 2000-November 2011. They were randomly matched for age, sex, and BMI at time of polysomnogram into the following groups: BE but no OSA (n = 36), OSA but no BE (n = 78), both (n = 74), or neither (n = 74). Clinical and demographic variables were abstracted from medical records. The association between OSA and BE was assessed by using a multiple variable logistic model that incorporated age, sex, BMI, clinical diagnosis of GERD, and smoking history.
  
  
  RESULTS
  Subjects with OSA had an 80% increased risk for BE compared with subjects without OSA (odds ratio, 1.8; 95% confidence interval, 1.1-3.2; P = .03). These findings were independent of age, sex, BMI, GERD, and smoking history. Increasing severity of OSA, measured by using the apnea-hypopnea index, was associated with an increased risk of BE (odds ratio, 1.2 per 10-unit increase in apnea-hypopnea index; 95% confidence interval, 1.0-1.3; P = .03).
  
  
  CONCLUSIONS
  In this case-control study, OSA was associated with an increased risk of BE, potentially through BMI and GERD independent mechanisms. Patients with OSA may benefit from evaluation for BE.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Cadman L
authors.initials: CL
authors.lastname: Leggett
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Emmanuel C
authors.initials: EC
authors.lastname: Gorospe
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Calvin
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors.forename: William S
authors.initials: WS
authors.lastname: Harmsen
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Zinsmeister
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Sean
authors.initials: S
authors.lastname: Caples
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Kelly
authors.initials: K
authors.lastname: Dunagan
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Lori
authors.initials: L
authors.lastname: Lutzke
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Kenneth K
authors.initials: KK
authors.lastname: Wang
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. Electronic address: iyer.prasad@mayo.edu.
authors.forename: Prasad G
authors.initials: PG
authors.lastname: Iyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*
keywords: Esophageal Adenocarcinoma; Obesity; Screening; Sleep-related Breathing Disorder
references.citation: Am J Med. 2000 Mar 6;108 Suppl 4a:120S-125S
references.pmid: 10718464
references.citation: Diabetes Res Clin Pract. 2009 Jan;83(1):100-5
references.pmid: 19019478
references.citation: Ann Intern Med. 2005 Feb 1;142(3):187-97
references.pmid: 15684207
references.citation: Chest. 2010 Mar;137(3):711-9
references.pmid: 20202954
references.citation: Chest. 2009 Jul;136(1):125-129
references.pmid: 19255295
references.citation: Lancet. 2012 Dec 15;380(9859):2197-223
references.pmid: 23245608
references.citation: Obes Surg. 2008 Nov;18(11):1479-84
references.pmid: 18418659
references.citation: Chest. 2010 Apr;137(4):769-76
references.pmid: 19914981
references.citation: Chest. 2006 Oct;130(4):1003-8
references.pmid: 17035431
references.citation: N Engl J Med. 2006 Jun 1;354(22):2340-8
references.pmid: 16738270
references.citation: Ann Otol Rhinol Laryngol. 2007 Nov;116(11):805-11
references.pmid: 18074664
references.citation: Mayo Clin Proc. 2013 Feb;88(2):157-65
references.pmid: 23374619
references.citation: Gastroenterology. 2007 Aug;133(2):403-11
references.pmid: 17681161
references.citation: Free Radic Biol Med. 2006 May 15;40(10):1683-92
references.pmid: 16678006
references.citation: Gastroenterology. 1996 Jul;111(1):85-92
references.pmid: 8698230
references.citation: Arch Surg. 2001 Sep;136(9):1014-8
references.pmid: 11529823
references.citation: Am J Gastroenterol. 2005 Oct;100(10):2151-6
references.pmid: 16181362
references.citation: Metab Syndr Relat Disord. 2009 Aug;7(4):271-8
references.pmid: 19344228
references.citation: Neurogastroenterol Motil. 2010 Jun;22(6):611-e172
references.pmid: 20236246
references.citation: Gastroenterology. 2007 Jul;133(1):34-41; quiz 311
references.pmid: 17631128
references.citation: Gastrointest Endosc. 2009 May;69(6):1004-10
references.pmid: 19152897
references.citation: Chest. 1992 Jun;101(6):1539-44
references.pmid: 1600771
references.citation: World J Gastroenterol. 2005 Feb 14;11(6):839-41
references.pmid: 15682476
references.citation: Clin Gastroenterol Hepatol. 2012 Jul;10(7):728-34; quiz e61-2
references.pmid: 22433923
references.citation: Sleep. 1989 Oct;12(5):475-6
references.pmid: 2799220
references.citation: Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):566-70
references.pmid: 10934088
references.citation: Chest. 2004 Jun;125(6):2101-6
references.pmid: 15189928
references.citation: Eur Respir J. 1999 Dec;14(6):1266-70
references.pmid: 10624753
references.citation: J Gastroenterol Hepatol. 2010 May;25 Suppl 1:S41-4
references.pmid: 20586864