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Gastroesophageal Reflux Causing Sleep Interruptions in Infants.
MedLine Citation:
PMID:  23201711     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Little is known about the relationship between gastroesophageal reflux (GER) episodes and sleep interruptions infants. AIM:: To evaluate the relationship between GER and the incidence of sleep interruptions in infants. METHODS:: Study patients included 24 infants (age < 1 yr) referred for multichannel intraluminal impedance and esophageal pH monitoring with simultaneous polysomnography. Exclusion criteria were a previous fundoplication and studies lasting less than 20 hours. Tests were clinically indicated to investigate suspicion of GER-related apnea (17, 70.8%), stridor (6, 25%), noisy breathing (2, 8.3%), and cyanotic spells (1, 4.2%). Most patients presented with significant co-morbidities (19, 79.2%). RESULTS:: The number of non-acid GER (NAGER) per hour was greater during sleep time than during daytime and awakening following sleep onset (median 0.27 vs. 1.85 and 1.45, p < 0.01). A total of 1204 (range 7-86 per infant) arousals in 24 infants was detected; 165 (13.7%) that followed GER episodes and 43 (3.6%) that preceded GER episodes. Seven patients presented with a positive symptom association probability (SAP) for arousals; 5 were exclusively due to NAGER. A positive SAP for awakenings was detected in 9 patients; 4 were due to NAGER, 4 were due to AGER, and 1 was due to both NAGER and GER. Patients with awakenings related to GER presented longer mean clearance time of AGER during sleep (165.5 vs 92.8 sec, p = 0.03). CONCLUSIONS:: GER was a frequent cause of interrupting sleep among our infant patients, and NAGER proved to be equally as important as AGER for causing arousals and awakenings in infants.
Authors:
Rodrigo Machado; Frederick W Woodley; Beth Skaggs; Carlo Di Lorenzo; Mark Splaingard; Hayat Mousa
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-27
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-12-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Department of Pediatrics, Federal University of São Paulo (UNIFESP) †Division of Gastroenterology, Hepatology and Nutrition ‡Sleep Laboratory, Division of Pulmonary Medicine, Nationwide Children's Hospital §Department of Pediatrics, The Ohio State University College of Medicine.
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