Re: What are my options?
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Re: What are my options?

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Posted by bruinmd on January 21, 2009 at 12:46:15:

In Reply to: Re: What are my options? posted by SomeDudeinCali on January 21, 2009 at 12:28:37:

Mike,

Here is an abstract that looks at GERD and Sleep apnea. It basically says that by treating the apnea with CPAP- the gerd improved significantly. So the two options could be
1)The reflux triggers the oxygen desaturation. It could probably happen- many speculate that sudden infant death syndrome may have a component of GERD (Not up on this literature though)

2)The apnea triggered the GERD episode. During an apnea, the negative pressure in your upper airway increases which can increase the driving force of the acid from the stomach to the esophagus and up into your airway. So treating the apnea would decrease the severity of the reflux episode as the abstract suggests. So these are just theories. Some studies show that treating the GERD will independently reduce the apnea index. You could try the theory out by not eating before bed and takng prilosec 20 before breakfast. Not sure why your heart rate would speed up in the morning. Unless it was just a big jolt to your system. The other consideration would be if you have asthma at all. Sometimes your asthma could be acting up on those days- and certainly reflux at night could make that worse in the morning.

And again- I would probably not go the UP3 route.

STUDY OBJECTIVES: Patients with obstructive sleep apnea (OSA) have a very high incidence of gastroesophageal reflux (GER). Previous studies have shown that the use of continuous positive airway pressure (CPAP) reduces the frequency of reflux events, but these studies only assessed the effect of a single night of treatment. The aim of this study was to assess the effect of 1 week of CPAP treatment on reflux in patients with OSA and GER. DESIGN: Sixteen patients with OSA and GER were recruited. Polysomnography followed by 24-h, continuous esophageal pH monitoring were performed at baseline. Patients with an apnea-hypopnea index (AHI) > 20/h and 24-h acid contact time (ACT) of at least 6% were included. As part of the polysomnography-qualifying evaluation, all patients underwent CPAP titration to reduce the AHI to < 10/h. Patients were then sent home receiving nasal CPAP for 1 week; after 1 week, esophageal pH monitoring was repeated while receiving CPAP. MEASUREMENTS AND RESULTS: The AHI fell from 63.3 +/- 38.5 to 3.2 +/- 2.2/h (mean +/- SD) [p < 0.001]. Total ACT fell from 13.9 +/- 11.6 to 5.6 +/- 2.7% (p < 0.001). The upright ACT was reduced from 12.4 +/- 6.8 to 6.8 +/- 3.8% (p = 0.01), and the supine (during the sleeping interval) ACT was reduced from 16.3 +/- 18.8 to 3.8 +/- 7.6% (p < 0.01). Eighty-one percent of the patients had a reduction in supine ACT to within the normal range (< 4%). CONCLUSIONS: In OSA patients with significant heartburn complaints, CPAP would appear to be an efficacious approach to the treatment of both disorders.

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