title: Does CPAP treatment lead to gastroesophageal reflux in patients with moderate and severe OSA?
abstract: Obstructive sleep apnea (OSA) leads to upper respiratory tract obstruction, causing increased abdominal-gastric pressure and decreased lower esophageal sphincter (LES) pressure and thus gastroesophageal reflux (GER). Continuous positive airway pressure (CPAP) is known to be an effective method for OSA treatment, but its effect on GER is still controversial. There are a very few studies investigating CPAP and GER relationship and performed based on pre- and post-treatment objective parameters of GER in patients with OSA. The study investigated the effect of CPAP treatment in patients with moderate and severe OSA without GER complaints on pre- and post-treatment objective GER parameters. The study included 25 patients with respiratory disturbance indices >15 without reflux symptoms who had undergone polysomnography at sleep laboratory. Age, sex, body mass index (BMI), waist, and neck circumference of the patients were documented. DeMeester score, LES pressure, and polysomnography parameters were evaluated pre- and post-CPAP. The results were statistically evaluated, and p value <0.05 is considered significant. Out of 25 patients, 21 were male (84 %) and mean age was 49.2 ± 8.6 (range 31-66). At the pre-CPAP phase, mean sphincter pressure was 22.2 ± 1.2 (range 8-73), and mean DeMeester score was 18 ± 15.5 (range 0.2-57). At the post-CPAP, mean sphincter pressure was 22.9 ± 1.6 (range 9-95), and mean DeMeester score was 16.3 ± 14.8 (range 0.2-55). No significant difference (p > 0.05) was found comparing pre-CPAP and post-CPAP measurements. Objective criteria show that CPAP treatment does not cause reflux in patients with OSA. Unlike studies reported in the literature, this conclusion has been reached by pre- and post-CPAP assessments.
authors.affiliation: Department of Chest Diseases, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Ozcelik
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Bezmialem Vakıf University, Istanbul, Turkey. ykayar@yahoo.com.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Kayar
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Danalioglu
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Arabaci
authors.affiliation: Department of Biostatistic, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Uysal
authors.affiliation: Department of Chest Diseases, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Yakar
authors.affiliation: Department of Chest Diseases, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Kart
mesh_terms: D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D014421:Turkey
keywords: Continuous positive airway pressure; Gastroesophageal reflux; Obstructive sleep apnea