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

Kelly Shepherd; David Hillman; Peter Eastwood

doi:10.5664/jcsm.2328

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Journal article

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

Kelly Shepherd, David Hillman and Peter Eastwood

Journal of clinical sleep medicine, Vol.9(1), pp.13-17

2013

DOI: https://doi.org/10.5664/jcsm.2328

PMCID: PMC3525982

PMID: 23319899

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Abstract

aerophagia

continuous positive airway pressure

gastroesophageal reflux

sleep apnea

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). Conclusion 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.

Details

Title: Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux
Authors/Creators: Kelly Shepherd - West Australian Sleep Disorders Research Institute
David Hillman - West Australian Sleep Disorders Research Institute
Peter Eastwood - West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia School of Anatomy and Human Biology, University of Western Australia, Crawley, Australia
Publication Details: Journal of clinical sleep medicine, Vol.9(1), pp.13-17
Publisher: American Academy of Sleep Medicine
Identifiers: 991005592656607891
Murdoch Affiliation: Vice Chancellery
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.95 Gastrointestinal & Esophageal Diseases; 1.95.541 GERD & Achalasia
Web Of Science research areas: Clinical Neurology
ESI research areas: Neuroscience & Behavior