Impact of Severe Obstructive Sleep Apnea on Symptoms of Gastroesophageal Reflux Disease: A Single-Clinic Prospective Case Study

抄録

　Purpose: Patients with obstructive sleep apnea (OSA) often have gastroesophageal reflux disease (GERD). However, it is controversial whether OSA causes GERD. Therefore, we prospectively investigated whether OSA is an independent factor for the symptoms of GERD.

　Methods: This study investigated the impact of severe OSA on the comorbidity of symptoms of GERD in 170 subjects under 65 years old and 51 subjects 65 years old or older. OSA was diagnosed with polysomnography, and subjects with symptoms of GERD were defined as those with a frequency scale for the symptoms of GERD (FSSG) score ≥8 points.

　Results: The average age and body mass index (BMI) of the subjects (n ＝ 221) were 54.0 ± 13.6 years old and 26.1 ± 5.0 kg/m². Men accounted for 76％ of the subjects. The average apnea hypopnea index of the subjects was 32.8 ± 20.3 events/h, and 46％ of the subjects had severe OSA. The average FSSG score of the subjects was 8.2 ± 7.1 points, and 44％ of the subjects had symptoms of GERD as defined in this study. In subjects younger than 65 years old, the cumulative percentage of time at saturation below 90％ was an independent factor for having GERD symptoms in the multivariate analysis (odds ratio, 1.04; 95％ confidence interval, 1.00-1.08; P ＝ 0.023). Subjects under 65 years old with severe OSA had an odds ratio of 3.00 for the comorbidity of symptoms of GERD (95％ confidence interval, 1.42–6.57; P ＝ 0.004) compared with those without severe OSA, after adjusting for BMI.

　Conclusions: Comorbidity of symptoms of GERD was not uncommon in OSA patients. The effect of severe OSA on the symptoms of GERD was greater in younger subjects than in older subjects.