Is there a relationship between obstructive sleep apnea and gastroesophageal reflux disease?

Background & Aims: The causative relationship between obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) remains an area of controversy. The aim of the study is to further explore the relationship between OSA and GERD in a large group of patients with OSA. Methods: One hundred thirty-six patients referred for polysomnographic studies at the University of Arizona Sleep Center were included in this study. All patients were assessed by means of a demographic survey, the validated GERD Symptom Checklist, and the Sleep Heart Health Study Sleep Habits Questionnaire. Polysomnograms were scored for objective measures of sleep and breathing. OSA is defined as an apnea-hypopnea index > 5 with compatible symptoms. Results: Of the 136 subjects, 101 (74%) were found to have OSA. Self-report of heartburn or acid regurgitation symptoms was unrelated to severity of sleep apnea. Additionally, OSA was not influenced by the severity of GERD. Objective measures of disordered sleep had stronger associations with age, smoking, and alcohol use than GERD in men and stronger associations with age and body mass index than GERD in women. Subjectively reported sleep quality was affected more strongly by GERD severity than by age, smoking, alcohol use, or the presence of OSA. Only females administered antireflux medications were less likely to report poor sleep quality. Conclusions: Subjective reports of sleep quality were affected by GERD severity, but an objective correlation between OSA and GERD was lacking. This may suggest that GERD and OSA are common entities that share similar risk factors, but appear not to be causally linked.