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Obstructive sleep apnea syndrome and gastroesophageal reflux disease: the importance of obesity and gender

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Abstract

Background

It is claimed that gastroesophageal reflux disease (GERD) increases in patients with obstructive sleep apnea syndrome (OSAS). We aimed to evaluate the prevalence of GERD in patients with OSAS and primary snoring and identify OSAS-related risk factors associated with GERD.

Methods

In this prospective, cross-sectional, multicenter study, in total 1,104 patients were recruited for polysomnography: 147 subjects were in non-OSAS (primary snoring) and 957 patients were in OSAS group. All patients completed a validated GERD questionnaire. Demographic, anthropometric characteristics, and medical history were recorded.

Results

The prevalence of GERD was similar in OSAS (38.9 %) and non-OSAS (32.0 %) groups (p = 0.064). There was no difference in terms of major gastroesophageal reflux (GER) symptoms (heartburn/acid regurgitation) between non-OSAS and mild, moderate, and severe OSAS groups. The prevalence of GERD was increased in female OSAS patients (46.6 %) compared to males (35.7 %) (p = 0.002). In OSAS patients with GERD, body mass index was greater (34.0 ± 7.0 vs. 33.1 ± 6.8, p = 0.049), waist (115.5 ± 13.9 vs. 113.1 ± 13.4, p = 0.007) and hip (117.9 ± 13.7 vs. 114.2 ± 12.8, p < 0.0001) circumferences were larger, and Epworth sleepiness scores were higher (10.3 ± 6.0 vs. 8.8 ± 5.6, p < 0.0001) than OSAS patients without GERD. Multivariate analysis showed that GERD was significantly associated with female gender, hip circumference, and daytime sleepiness.

Conclusions

In this large cohort, the prevalence of GERD was significantly increased in those with primary snoring and OSAS compared to the general population, but severity of OSAS did not influence GERD prevalence. The present results suggest that OSAS was not likely a causative factor but female gender, obesity, and sleepiness were related with prevalence of GERD in OSAS patients.

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Abbreviations

AHI:

Apnea-hypopnea index

BMI:

Body mass index

GER:

Gastroesophageal reflux

GERD:

Gastroesophageal reflux disease

NS:

Not significant

OSAS:

Obstructive sleep apnea syndrome

REM:

Rapid eye movement

SDB:

Sleep-disordered breathing

SpO2 :

Pulse oximeter oxygen saturation

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Conflict of interest

The manuscript entitled “Obstructive sleep apnea syndrome and gastroesophageal reflux disease: the importance of obesity and gender” which we submit for consideration to be published in Sleep and Breathing is not under consideration for publication nor published elsewhere.

The investigation was performed at the Ege University Faculty of Medicine, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, and Katip Celebi University Faculty of Medicine. The work has been seen and approved by all coauthors. The authors have no proprietary, financial, professional, or other personal interest of any nature or kind in any product, service, and/or company that could be construed as influencing the position presented in, or the review of, the manuscript.

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Authors and Affiliations

  1. Department of Chest Diseases, Ege University Faculty of Medicine, Bornova, 35100, Izmir, Turkey

    Ozen K. Basoglu & Mehmet Sezai Tasbakan

  2. Section of Gastroenterology and Ege Reflux Study Group, Ege University Faculty of Medicine, Bornova, 35100, Izmir, Turkey

    Rukiye Vardar & Serhat Bor

  3. Department of Sleep Disorders, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Yenisehir, Izmir, Turkey

    Zeynep Zeren Ucar

  4. Department of Chest Diseases, Katip Celebi University Faculty of Medicine, Izmir, Turkey

    Sibel Ayik

  5. Department of Biostatistics, Ege University Faculty of Medicine, Izmir, Turkey

    Timur Kose

Authors
  1. Ozen K. Basoglu
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  2. Rukiye Vardar
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  3. Mehmet Sezai Tasbakan
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  4. Zeynep Zeren Ucar
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Correspondence to Ozen K. Basoglu.

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Basoglu, O.K., Vardar, R., Tasbakan, M.S. et al. Obstructive sleep apnea syndrome and gastroesophageal reflux disease: the importance of obesity and gender. Sleep Breath 19, 585–592 (2015). https://doi.org/10.1007/s11325-014-1051-4

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  • DOI: https://doi.org/10.1007/s11325-014-1051-4

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