Gastroesophageal reflux and obstructive sleep apnea in childhood

Summary Objectives To examine the relationship between gastroesophageal reflux (GER) and obstructive sleep apnea syndrome (OSAS) with polysomnographic alterations and symptom severity. Patients and methods Eighteen children aged from 6 to 12 years (8.14 ± 1.75) with adenotonsillar hypertrophy and OS...

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Published in:	International journal of pediatric otorhinolaryngology Vol. 73; no. 3; pp. 383 - 389
Main Authors:	Noronha, Alessandra Caland, de Bruin, Veralice Meireles Sales, e Souza, Miguel Ângelo Nobre, de Freitas, Marcos Rabelo, de Paula Araújo, Roberta, Mota, Rosa Maria Salani, de Bruin, Pedro Felipe Carvalhedo
Format:	Journal Article
Language:	English
Published:	Ireland Elsevier Ireland Ltd 01-03-2009
Subjects:	Adenoids - pathology Apnea Child Children Esophageal pH Monitoring Female Gastroesophageal reflux Gastroesophageal Reflux - complications Gastroesophageal Reflux - diagnosis Humans Hypertrophy Male Otolaryngology Palatine Tonsil - pathology Pediatrics pH monitoring Polysomnography Sleep Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - diagnosis Sleep Apnea, Obstructive - pathology Gastroesophageal reflux Sleep Apnea Children pH monitoring Polysomnography
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Summary:	Summary Objectives To examine the relationship between gastroesophageal reflux (GER) and obstructive sleep apnea syndrome (OSAS) with polysomnographic alterations and symptom severity. Patients and methods Eighteen children aged from 6 to 12 years (8.14 ± 1.75) with adenotonsillar hypertrophy and OSAS were evaluated with the OSA-18 questionnaire nasofibrolaringoscopy and full overnight polysomnography performed simultaneously with esophageal pH monitoring. Results OSAS (Apnea-index (AI) ≥ 1/hour) was present in all cases. Reflux parameters did not correlate to OSAS severity and a temporal relationship between GER and apnea–hypopnea events was not observed. Body mass index was lower than 18 in 9 cases (52.9%) and 7 children (41.1%) presented a history of abnormal behavior during sleep. In most cases oxygen desaturation and reduction of sleep efficiency were mild. Sleep architecture was similar to the young adult pattern. Seven children (41.1%) presented pH monitoring values below 4 during more than 10% of total sleep time. pH monitoring values were correlated to emotional distress ( p = 0.008) and to daytime problems ( p = 0.03) as evaluated by the OSA-18. Conclusions GER is frequent and should be assessed in children from 6 to 12 years with OSAS. Emotional distress and daytime problems are correlated to increased GER severity.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0165-5876 1872-8464
DOI:	10.1016/j.ijporl.2008.11.002