Document Detail


Upper esophageal sphincter and gastroesophageal junction pressure changes act to prevent gastroesophageal and esophagopharyngeal reflux during apneic episodes in patients with obstructive sleep apnea.
MedLine Citation:
PMID:  19914981     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Gastroesophageal reflux (GER) is thought to be induced by decreasing intraesophageal pressure during obstructive sleep apnea (OSA). However, pressure changes in the upper esophageal sphincter (UES) and gastroesophageal junction (GEJ) pressure during OSA events have not been measured. The aim of this study was to determine UES and GEJ pressure change during OSA and characterize the GER and esophagopharyngeal reflux (EPR) events during sleep. METHODS: We studied 15 controls, nine patients with GER disease (GERD) and without OSA, six patients with OSA and without GERD, and 11 patients with both OSA and GERD for 6 to 8 h postprandially during sleep. We concurrently recorded the following: (1) UES, GEJ, esophageal body (ESO), and gastric pressures by high-resolution manometry; (2) pharyngeal and esophageal reflux events by impedance and pH recordings; and (3) sleep stages and respiratory events using polysomnography. End-inspiration UES, GEJ, ESO, and gastric pressures over intervals of OSA were averaged in patients with OSA and compared with average values for randomly selected 10-s intervals during sleep in controls and patients with GERD. RESULTS: ESO pressures decreased during OSA events. However, end-inspiratory UES and GEJ pressures progressively increased during OSA, and at the end of OSA events were significantly higher than at the beginning (P < .01). The prevalence of GER and EPR events during sleep in patients with OSA and GERD did not differ from those in controls, patients with GERD and without OSA, and patients with OSA and without GERD. CONCLUSIONS: Despite a decrease in ESO pressure during OSA events, compensatory changes in UES and GEJ pressures prevent reflux.
Authors:
Shiko Kuribayashi; Benson T Massey; Muhammad Hafeezullah; Lilani Perera; Syed Q Hussaini; Linda Tatro; Ronald J Darling; Rose Franco; Reza Shaker
Publication Detail:
Type:  Journal Article     Date:  2009-11-13
Journal Detail:
Title:  Chest     Volume:  137     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-04-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  769-76     Citation Subset:  AIM; IM    
Affiliation:
Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Case-Control Studies
Esophageal Sphincter, Upper / physiology*
Esophageal pH Monitoring
Esophagogastric Junction / physiology*
Exhalation / physiology
Female
Gastroesophageal Reflux / physiopathology,  prevention & control*
Humans
Inhalation / physiology
Male
Manometry
Middle Aged
Polysomnography
Regurgitation, Gastric / physiopathology,  prevention & control*
Sleep Apnea, Obstructive / physiopathology*
Young Adult
Comments/Corrections
Comment In:
Chest. 2010 Apr;137(4):747-8   [PMID:  20371523 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Semiqualitative Visual and Quantitative Morphometric Evaluations of Reduced Scan Time and Wide-Beam ...
Next Document:  National networks of Healthy Cities in Europe.