Clinical course and cardio-respiratory monitoring of patients with obstructive sleep apnea and gastroesophageal reflux disease

• Main Authors: V. I. Kryvenko, O. A. Svitlytska
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2020-04-01
• Series: Zaporožskij Medicinskij Žurnal
• Subjects: obstructive sleep apnea; gastroesophageal reflux disease; cardio-respiratory disorders
• Online Access: http://zmj.zsmu.edu.ua/article/view/200580/201020
• ISSN: 2306-4145; 2310-1210

Purpose. To study the obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) combined course characteristics based on clinical studies and cardio-respiratory monitoring. Materials and methods. 125 patients were examined: group I – 31 patients with GERD, group II – 32 patients with OSA, group III – 62 patients with combined OSA and GERD. A cardio-respiratory study, esophagogastroduodenoscopy were performed. The severity of complaints was assessed on the Likert scale, GERD symptoms evaluation – on the F.S.S.G. Patients were questioned on a scale of reactive (RA) and personal (PA) anxiety by Spielberger–Khanin scale. Patients were tested for H. pylori infection by the stool-test. Results. Patients of group III, compared with patients of group I, showed a significant increase in complaints of reflux feeling (+64.4 %), cough (+41.3 %), heartbeat and feeling of interruptions in the heart (+71.6 %), dysphagia (+16.3 %) (P < 0.05). In group III, the magnitude of the component “reflux symptoms” according to F.S.S.G. was byn 1.5 times, and the component “symptoms of dysphagia” was by 1.7 times more than in group I (P < 0.05). In group III, moderate and severe degree of apnea was observed in patients (71 %), while in group II there were 17 patients (53 %). In patients of group ІІІ, the value of the PA indicator exceeded the analogous parameter in patients of group І by +35.7 % (P < 0.05), Group II – by +80.9 % (P < 0.05). Patients of group III had more severe course of GERD (according to endoscopic signs) (χ2 = 5.125, df = 2, P < 0.05). A significant interaction was determined between the degree of esophagus damage and H. pylori infection, the severity of OSA (respectively, γ = +0.46 and γ = +0.30, P < 0.05). Significant relationships were found between the severity of OSA and the severity of GERD symptoms, the duration of GERD, and H. pylori infection. Conclusions. Patients with a combined course of OSA and GERD have a mutual burdening syndrome, which worsens the course of two diseases.