The Relation between Gastroesophageal Reflux Disease and the Obstructive Sleep Apnea and the Effects of Continuous Positive Airway Pressure Treatment

Abstract

Abstract Background: Patients with OSA have a higher risk of GERD than non-OSA patients. However, there is a controversy between the OSA and GERD. Herein, we evaluated the prevalence and possible risk factors of GERD in OSA. We also observed the efficacy of continuous positive airway pressure (CPAP) therapy on these patients. Method: Home Sleep Apnea Test (HAST) and gastroesophageal reflux disease questionnaire (GERDQ) are used to diagnose OSA and GERD. A total of 600 OSA patients were concluded in this cross-sectional study. Of the patients with OSA complicated with GERD, 36 received CPAP, 24 received CPAP + proton pump inhibitor (PPI), and 33 received PPI. We followed patients with OSA complicated with GERD for 8 weeks. Result: This study identified a significant relationship between OSA and GERD, with a OR of 2.76 (95%CI 1.42-5.36, P=0.02). The prevalence of GERD in patients with mild, moderate, and severe OSA was 14.9%, 15.9%, and 56.9%, respectively. After 8 weeks of treatment, the GERDQ in the CPAP group was 6.89±1.14. The duration of symptom improvement in CPAP group was 5.43±2.02 weeks. The duration of symptom improvement in CPAP+PPI group was 4.23±1.6 weeks. and higher PPI discontinuation rate in CPAP+PPI group is 54.2%, and PPI group is 27.3%. Conclusion: OSA was independently associated with GERD. CPAP improved GER symptoms compared with the no-treatment group. CPAP+PPI treatment improved GERD more rapidly than PPI alone, and CPAP treatment was an independent protective factor for GERD.