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    Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux

    Access Status
    Fulltext not available
    Authors
    Shepherd, K.
    Hillman, D.
    Eastwood, Peter
    Date
    2013
    Type
    Journal Article
    
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    Citation
    Shepherd, K. and Hillman, D. and Eastwood, P. 2013. Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux. Journal of Clinical Sleep Medicine. 9 (1): pp. 13-17.
    Source Title
    Journal of Clinical Sleep Medicine
    DOI
    10.5664/jcsm.2328
    ISSN
    1550-9389
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/43299
    Collection
    • Curtin Research Publications
    Abstract

    Study Objectives: Continuous positive airway pressure (CPAP), the mainstay treatment for obstructive sleep apnea (OSA), involves administration of air under pressure to the upper airway. A well-known but poorly understood side effect of positive airway pressure therapies is aerophagia, air entering the esophagus and stomach rather than the lungs. Gastric distension, a consequence of aerophagia, can increase gastroesophageal reflux (GER) by increasing transient lower esophageal sphincter relaxations, the most common cause of reflux. This study aimed to determine: (i) the prevalence of aerophagia symptoms in a group of OSA patients on CPAP therapy, and (ii) whether aerophagia symptoms are related to an increase in prevalence of GER symptoms. Methods: Consecutive OSA patients undergoing polysomnography for the purpose of optimizing their CPAP therapy completed a validated questionnaire regarding GER symptoms and aerophagia symptoms. Complete datasets were collected for 259 individuals (203 males). Results: The group with aerophagia symptoms (n = 130) had a greater prevalence of frequent (= once a week) GER symptoms (29% vs. 10%, p < 0.05) and nighttime GER symptoms (9 vs. 2%, p < 0.05) than those without aerophagia (n = 129). The group with nighttime GER symptoms (n = 27) had a greater prevalence of aerophagia symptoms (63% vs. 23%, p < 0.05) than those without nighttime GER symptoms (n = 232). Conclusions: In patients with OSA being treated with CPAP, the prevalence of GER and nighttime GER symptoms is greater in those with symptoms of aerophagia than those without. CPAP-induced aerophagia might precipitate GER, particularly nighttime GER, by exacerbating transient lower esophageal relaxations through gastric distension.

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