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Prevalence of GERD and Its Effect on Quality of Life in a Large Cohort of Patient with Obstructive Sleep Apnea

59

Green, Bryan, M.D.; Thorn, Michael, DrPH; OConnor, J. Barry, M.D.

American Journal of Gastroenterology: September 2005 - Volume 100 - Issue - p S42–S43
Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: ESOPHAGUS
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GI, Digestive Disease Group, Greenville, SC; Stats, Statistical Resources Inc, Durham, NC and Medicine, Duke University Medical Center, Durham, NC.

Purpose: Determine the prevalence of GERD and its effect on quality of life in a large cohort of patients with sleep apnea.

Methods: 362 consecutive patients presenting for a nocturnal polysomnography (sleep study) between June 2003 and January 2005 completed self-administered questionnaires including demographics, GERD symptom frequency and severity within the previous week, GERD medication use and SF-36 prior to their sleep study. A respiratory disturbance index (RDI) ≥15 was used to define the presence of obstructive sleep apnea (OSA). GERD frequency was defined as the number of days and/or nights with GERD symptoms within the previous week. GERD severity scale was 0 (none) to 5 (very severe).

Results: Patients not meeting RDI criteria for OSA and those having a titration sleep study were excluded. Data on 168 patients were analyzed. Mean age was 50.8 years (SD 13.5; range 23–83). Gender: 64.9% male, 35.1% female. Race: 60.1% white, 39.9% non-white. Mean RDI = 26.8 (normal <15; SD 25.9). Daytime and nighttime GERD symptoms were experienced an average of 1.8 days (26%) and 1.6 nights (23%) respectively during the previous week. Daytime GERD severity was moderate or severe in 24% while nighttime GERD severity was moderate or severe in 31% during the previous week (despite therapy in some cases). H2-receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) were used by 23% and 26% respectively within the previous week. Compared to the US general population, our OSA patient had a much lower QOL score in all subscales of the SF-36 (except mental health). Concomitant moderate or severe nighttime GERD (score ≥2) was associated with worse QOL than no or mild GERD (Table).

Table

Table

Conclusions: GERD symptoms are common and frequently severe in patients with OSA. A substantial minority of patients with OSA use H2-RAs or PPIs. QOL is severely impaired in OSA. Coexistent moderate/severe nighttime GERD with OSA is associated with even worse QOL. All patients with sleep apnea should be evaluated for GERD. This study was supported by an AstraZeneca ISS grant.

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