Gastroesophageal reflux and obstructive sleep apnea in childhood

• 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
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2008.11.002

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.