Association Between Non-erosive Reflux Disease and High Risk of Obstructive Sleep Apnea in Korean Population.
OBJECTIVE
Obstructive sleep apnea is becoming more important in gastroesophageal reflux disease (GERD) patients. This study investigated the prevalence of high risk for obstructive sleep apnea in GERD patients in comparison with that in healthy controls using the Berlin Questionnaire. We also investigated the risk factors for obstructive sleep apnea in GERD patients.


METHODS
We enrolled 1,007 subjects: 776 healthy controls, 115 individuals with erosive reflux disease, and 116 with non-erosive reflux disease. GERD was diagnosed and classified using endoscopy and a reflux questionnaire. The Berlin Questionnaire was used to evaluate obstructive sleep apnea.


RESULTS
More patients in the GERD group (28.2%) had higher risk for obstructive sleep apnea than healthy controls (20.4%, P = 0.036). More patients with non-erosive disease (32.8%) had higher risk for obstructive sleep apnea (OSA) than patients with erosive disease (20.9%) and controls (20.4%, P = 0.010). On multivariate analysis, non-erosive disease was a high risk factor for obstructive sleep apnea (odds ratio [OR], 1.82; P = 0.011). Age ≥ 55 years (OR, 1.83; P < 0.001) and a high body mass index (≥ 25 kg/m(2)) (OR, 2.76; P < 0.001) were also identified as risk factors. Nocturnal GERD was related to high risk for OSA in non-erosive disease patients (OR, 2.97; P = 0.019), but not in erosive disease patients.


CONCLUSIONS
High risk for OSA is more prevalent in GERD patients than in controls. Non-erosive reflux disease, age ≥ 55, and a high BMI are associated with high risk for OSA.
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Chan Ran
CR
You
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Jung Hwan
JH
Oh
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Minji
M
Seo
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Hye Yeon
HY
Lee
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Hyonsoo
H
Joo
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Sung Hoon
SH
Jung
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Sang Haak
SH
Lee
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Myung-Gyu
MG
Choi
Esophagitis; Gastroesophageal reflux; Sleep apnea, obstructive