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Reflux and sleeping disorders: a systematic review

Published online by Cambridge University Press:  02 March 2009

P D Karkos*
Affiliation:
Department of Otolaryngology, Liverpool University Hospitals, UK
S C Leong
Affiliation:
Department of Otolaryngology, Liverpool University Hospitals, UK
J Benton
Affiliation:
Department of Otolaryngology, Liverpool University Hospitals, UK
A Sastry
Affiliation:
Department of Otolaryngology, Liverpool University Hospitals, UK
D A Assimakopoulos
Affiliation:
Department of Otorhinolaryngology, University of Ioannina Medical School, Greece
W J Issing
Affiliation:
Department of Otolaryngology, The Freeman Hospital, Newcastle Upon Tyne, UK
*
Address for correspondence: Mr P Karkos, 36 Hopkinsons Court, Walls Avenue, Chester CH1 4LN, UK. E-mail: pkarkos@aol.com

Abstract

Introduction:

Laryngopharyngeal reflux is perhaps the most extensively researched laryngology topic of the last decade. It has been suggested that some supraoesophageal symptoms, most notably asthma and laryngospasm, may be associated with night-time, or supine, reflux. The aim of this review was to assess the levels of evidence regarding a correlation between night-time reflux, snoring and apnoea.

Methods:

A Medline search was performed using the terms ‘reflux’, ‘night-time’, ‘larynx’, ‘gastroesophageal’, ‘laryngopharyngeal’, ‘sleep’, ‘apnoea’, ‘snoring’ and ‘ear nose throat’. The retrieved literature was reviewed, focusing on randomised and non-randomised, controlled, prospective trials. Papers on both paediatric and adult populations were included. Non-English language papers were excluded.

Results:

We found no randomised, controlled trials or meta-analyses addressing the possible correlation between reflux and snoring and/or apnoea.

Conclusions:

The role of night-time reflux in paediatric and adult snoring and apnoea is well described in the literature, but is based on poor levels of evidence from uncontrolled studies and case reports.

Type
Review Articles
Copyright
Copyright © JLO (1984) Limited 2009

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References

1 Altman, KW, Haines, GK 3rd, Hammer, ND, Radosevich, JA. The H+/K+-ATPase (proton) pump is expressed in human laryngeal submucosal glands. Laryngoscope 2003;113:1927–30CrossRefGoogle Scholar
2 Karkos, PD, Wilson, JA. Empiric treatment of laryngopharyngeal reflux with proton pump inhibitors: a systematic review. Laryngoscope 2006;116:144–8CrossRefGoogle ScholarPubMed
3 Gill, GA, Johnston, N, Buda, A, Pignatelli, M, Pearson, J, Dettmar, PW et al. Laryngeal epithelial defences against laryngopharyngeal reflux: investigations of E-cadherin, carbonic anhydrase isoenzyme III, and pepsin. Ann Otol Rhinol Laryngol 2005;114:913–21CrossRefGoogle ScholarPubMed
4 Tasker, A, Dettmar, PW, Panetti, M, Koufman, JA, Birchall, JP, Pearson, JP. Is gastric reflux a cause of otitis media with effusion in children? Laryngoscope 2002;112:1930–4CrossRefGoogle ScholarPubMed
5 Fass, R, Achem, SR, Mittal, RK, Quigley, E. Supraoesophageal manifestations of gastro-oesophageal reflux disease and the role of night-time gastro-oesophageal reflux. Aliment Pharmacol Ther 2004;20:2638CrossRefGoogle ScholarPubMed
6 Koufman, JA. Laryngopharyngeal reflux: a new paradigm of airway disease. Ear Nose Throat J 2002;81(suppl 2):26Google ScholarPubMed
7 Buts, JP, Barudi, C, Moulin, D, Claus, D, Cornu, G, Otte, JB. Prevalence and treatment of silent gastro-oesophageal reflux in children with recurrent respiratory disorders. Eur J Pediatr 1986;145:396400CrossRefGoogle ScholarPubMed
8 Zielińska, I, Czerwionka-Szaflarska, M. Assessment of the value of pHmetry results in diagnostics of gastroesophageal reflux as a cause of obstructive bronchitis in children. Med Sci Monit 2002;8:169–74Google ScholarPubMed
9 Goh, DY, Galster, P, Marcus, CL. Sleep architecture and respiratory disturbances in children with obstructive sleep apnea. Am J Respir Crit Care Med 2000;162:682–6CrossRefGoogle ScholarPubMed
10 Scholle, S, Zwacka, G. Arousals and obstructive sleep apnea syndrome in children. Clin Neurophysiol 2001;112:984–91CrossRefGoogle ScholarPubMed
11 Halpern, LM, Jolley, SG, Tunell, WP, Johnson, DG, Sterling, CE. The mean duration of gastroesophageal reflux during sleep as an indicator of respiratory symptoms from gastroesophageal reflux in children. J Pediatr Surg 1991;26:686–90CrossRefGoogle ScholarPubMed
12 Karkos, PD, Leong, SC, Apostolidis, T, Issing, WJ. Laryngeal manifestations and pediatric laryngo-pharyngeal reflux. Am J Otolaryngol 2006;27:200–3CrossRefGoogle Scholar
13 Walsh, JK, Farrell, MK, Keenan, WJ, Lucas, M, Kramer, M. Gastroesophageal reflux in infants: relation to apnea. J Pediatr 1981;99:197201CrossRefGoogle ScholarPubMed
14 Arad-Cohen, N, Cohen, A, Tirosh, E. The relationship between gastroesophageal reflux and apnea in infants. J Pediatr 2000;137:321–6CrossRefGoogle ScholarPubMed
15 Kerr, P, Shoenut, JP, Millar, T, Buckle, P, Kryger, MH. Nasal CPAP reduces gastroesophageal reflux in obstructive sleep apnoea syndrome. Chest 1992;101:1539–44CrossRefGoogle Scholar
16 Shepherd, KL, Holloway, RH, Hillman, DR, Eastwood, PR. The impact of continuous positive airway pressure on the lower esophageal sphincter. Am J Physiol Gastrointest Liver Physiol 2007;292:1200–5CrossRefGoogle ScholarPubMed
17 Tawk, M, Goodrich, S, Kinasewitz, G, Orr, W. The effect of 1 week of continuous positive airway pressure treatment in obstructive sleep apnea patients with concomitant gastroesophageal reflux. Chest 2006;130:1003–8CrossRefGoogle ScholarPubMed
18 Valipour, A, Makker, HK, Hardy, R, Emegbo, S, Toma, T, Spiro, SG. Symptomatic gastroesophageal reflux in subjects with a breathing sleep disorder. Chest 2002;121:1748–53CrossRefGoogle ScholarPubMed
19 Gunnbjornsdottir, MI, Omenaas, E, Gislason, T. Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms. Eur Respir J 2004;24:116–21CrossRefGoogle ScholarPubMed
20 Ulualp, S, Brodsky, L. Nasal pain disrupting sleep as a presenting symptom of extraesophageal acid reflux in chidren. Int J Pediatr Otorhinolaryngol 2005;69:1555–7CrossRefGoogle Scholar
21 Wasilewska, J, Kaczmarski, M. Sleep-related breathing disorders in small children with nocturnal acid gastro-oesophageal reflux. Rocz Akad Med Bialymst 2004;49:98102Google ScholarPubMed
22 Xu, Z, Cheuk, DK, Lee, SL. Clinical evaluation in predicting childhood obstructive sleep apnea. Chest 2006;130:1765–71CrossRefGoogle ScholarPubMed