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

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...

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Main Authors: Shepherd, K., Hillman, D., Eastwood, Peter
Format: Journal Article
Published: 2013
Online Access:http://hdl.handle.net/20.500.11937/43299
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author Shepherd, K.
Hillman, D.
Eastwood, Peter
author_facet Shepherd, K.
Hillman, D.
Eastwood, Peter
author_sort Shepherd, K.
building Curtin Institutional Repository
collection Online Access
description 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). Conclusions: 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.
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spelling curtin-20.500.11937-432992018-03-29T09:07:47Z Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux Shepherd, K. Hillman, D. Eastwood, Peter 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). Conclusions: 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. 2013 Journal Article http://hdl.handle.net/20.500.11937/43299 10.5664/jcsm.2328 restricted
spellingShingle Shepherd, K.
Hillman, D.
Eastwood, Peter
Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux
title Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux
title_full Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux
title_fullStr Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux
title_full_unstemmed Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux
title_short Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux
title_sort symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux
url http://hdl.handle.net/20.500.11937/43299