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Volume 15 No. 10
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Accepted Papers





Scientific Investigations

Temporal Association Between Respiratory Events and Reflux in Patients With Obstructive Sleep Apnea and Laryngopharyngeal Reflux

Sandra Doria Xavier, PhD1; Claudia Alessandra Eckley, PhD1; André Campos Duprat, PhD1; Luiz Henrique de Souza Fontes, PhD2; Tomás Navarro-Rodriguez, PhD2; Julio Patrocínio, MD3; Daniela Tridente, MD4; Geraldo Lorenzi-Filho, PhD5
1Otolaryngology Department,Santa Casa São Paulo, São Paulo, Brazil; 2Esophagus and Digestive Motility of Gastroenterology, Department of Hospital Clínicas, São Paulo University, São Paulo, Brazil; 3Head and Neck Department, Santa Casa São Paulo, São Paulo, Brazil; 4Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; 5InCor Sleep Center Laboratory Director, São Paulo, Brazil

Study Objectives:

The aim of the current study was to test the hypothesis that there is a temporal correlation between reflux episodes and respiratory events in patients with laryngopharyngeal reflux and obstructive sleep apnea.

Methods:

Adults with clinically diagnosed laryngopharyngeal reflux confirmed by two validated instruments (reflux symptom index ≥ 13 and reflux finding score ≥ 7) and obstructive sleep apnea (OSA) underwent full polysomnography with concomitant and synchronized multichannel intraluminal impedance-pH esophageal monitoring. The apnea-hypopnea and arousal indexes that occurred 15, 30, and 45 minutes before and after each reflux episode were recorded and compared to full-night apnea and hypopnea and arousal index.

Results:

We studied 27 patients (14 males, age 51.7 ± 9.1 years, body mass index 32.4 ± 4.2 kg/m2) with laryngopharyngeal reflux (reflux symptom index 16 ± 2 and reflux finding score 12 ± 3) and OSA (apnea-hypopnea index = 32.3 ± 28.4 events/h). We evaluated 102 reflux episodes. Almost half of the reflux episodes occurred while awake (43.1%) and only five reflux episodes (4.9%) occurred during an obstructive respiratory event. The apnea and hypopnea and arousal indexes 15, 30, and 45 minutes before and after reflux episodes were lower than full-night apnea and hypopnea and arousal indexes, respectively.

Conclusions:

Among patients with well-established laryngopharyngeal reflux and OSA, there is no temporal association between reflux and obstructive respiratory events. Even though the data comprised a small sample size, it seems that a more complex mechanism is involved with these two highly prevalent diseases.

Citation:

Xavier SD, Eckley CA, Duprat AC, de Souza Fontes LH, Navarro-Rodriguez T, Patrocínio J, Tridente D, Lorenzi-Filho G. Temporal association between respiratory events and reflux in patients with obstructive sleep apnea and laryngopharyngeal reflux. J Clin Sleep Med. 2019;15(10):1397–1402.




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