[Nocturnal Gastroesophageal Reflux and Sleep Apnea: What Relationship?]

Background: Gastroesophageal reflux disease and nocturnal sleep disturbances are frequently encountered in clinical practice and are often associated. However, the combination of these two syndromes does not necessarily imply a cause and effect. In a more precise, the relationship between nocturnal gastroesophageal reflux and sleep apnea syndrome has been debated since even if their respective prevalences are high in the presence of one or the other syndrome, it is difficult to eliminate mutual induction.

Aim: To determine the pathophysiological relations, the frequency of the association between nocturnal gastroesophageal reflux and sleep apnea syndrome and the impact of specific therapies to each of these two syndromes on the other.

Methods: Review of the literature.

Results: On the relationship between these two entities, it seems obvious that nocturnal gastroesophageal reflux affects the normal physiology of sleep and alters its quality and that the sleep apnea syndrome can aggravate reflux. On the frequency of their association, gastroesophageal reflux was observed in the presence of sleep apnea syndrome; in 27 to 75% of patients in studies that do not include pH-metric and polysomnographic recording simultaneously. Regarding treatment, continuous positive airway pressure seems to improve night time gastroesophageal reflux both in terms of symptoms that pH-metric results. Similarly, inhibitors of proton pump inhibitors have demonstrated their effectiveness in combination with specific treatment, in improving symptoms caused by sleep apnea syndrome.

Conclusion: we can confirm that there is a strong link between nocturnal gastroesophageal reflux and sleep apnea syndrome but causality is hard to be confirmed. Moreover, it seems useful to look for sleep disorders in patients with nocturnal gastroesophageal reflux also to suggest the diagnosis of gastroesophageal reflux in patients with sleep apnea syndrome.