Sleep Apnea Treatment Eases GERD

Popular Treatment May Prevent Nighttime Acid Reflux

From the WebMD Archives

Jan. 14, 2003 -- A common treatment for sleep apnea may also ease the discomfort and sleeping problems brought on by nighttime heartburn and acid reflux. A new study shows that many people suffer from both disorders at the same time, and use of a therapy that delivers a continuous, forced flow of air through the airway may help prevent acid from regurgitating.

Severe heartburn and acid regurgitation that causes sleep disturbances is known as nocturnal gastroesophageal reflux disease, or nighttime GERD. Researchers estimate that about 10% of the general population suffers from nighttime GERD, but their study shows that 62% of people with obstructive types of sleep apnea or breathing interruptions that last 10 seconds or longer during sleep also suffer from nighttime heartburn and acid reflux.

But the study also shows that sleep apnea patients who used a treatment called continuous positive airway pressure (CPAP), which delivers a continuous flow of forced air through the nostrils, experienced a significant reduction in the frequency and severity of their nighttime GERD symptoms.

The results appear in the Jan. 13 issue of the Archives of Internal Medicine.

Researchers studied 331 patients diagnosed with obstructive sleep apnea who were undergoing treatment at the University of South Alabama Sleep Disorders Clinic from 1993 to 2000. Of these patients, 62% reported problems with nighttime GERD, and 189 of these patients were treated with CPAP to relieve their sleep apnea.

The treatment consists of wearing a mask during sleep that is attached to a machine and delivers forced air through the nose to keep the airway open, preventing any breathing interruptions. The device does not cure the condition and must be used every night for best results.

Three years after initiating the treatment, researchers found 91% of the patients were still using CPAP and 9% had discontinued it due to discomfort or nasal dryness.

Those people who continued using CPAP had an almost 50% drop in the frequency of GERD symptoms. Those patients who stopped using CPAP had no improvement in the frequency of GERD symptoms.

In addition, 75% of patients using CPAP saw an improvement the severity of GERD symptoms, compared with only 31% of the non-users.

Study author Bryan T. Green, MD, and colleagues at Duke University Medical Center say they believe CPAP prevents nighttime GERD symptoms by increasing pressure in the chest and transmitting that pressure onto the esophagus, preventing acid from coming back up. The study shows that the higher the force of air to the nose and into the airways, the greater the improvement in symptoms.

SOURCE: Archives of Internal Medicine, Jan. 13, 2003.