Pediatr Gastroenterol Hepatol Nutr.  2016 Mar;19(1):12-19. 10.5223/pghn.2016.19.1.12.

Gastroesophageal Reflux Affects Sleep Quality in Snoring Obese Children

• Machado RS
• Woodley FW
• Skaggs B
• Lorenzo CD
• Eneli I
• Splaingard M
• Mousa H

• KMID: 2160471
• DOI: http://doi.org/10.5223/pghn.2016.19.1.12

Abstract

PURPOSE
This study was performed to evaluate the quality of sleep in snoring obese children without obstructive sleep apnea (OSA); and to study the possible relationship between sleep interruption and gastroesophageal reflux (GER) in snoring obese children.
METHODS
Study subjects included 13 snoring obese children who were referred to our sleep lab for possible sleep-disordered breathing. Patients underwent multichannel intraluminal impedance and esophageal pH monitoring with simultaneous polysomnography. Exclusion criteria included history of fundoplication, cystic fibrosis, and infants under the age of 2 years. Significant association between arousals and awakenings with previous reflux were defined by symptom-association probability using 2-minute intervals.
RESULTS
Sleep efficiency ranged from 67-97% (median 81%). A total of 111 reflux episodes (90% acidic) were detected during sleep, but there were more episodes per hour during awake periods after sleep onset than during sleep (median 2.3 vs. 0.6, p=0.04). There were 279 total awakenings during the sleep study; 56 (20.1%) of them in 9 patients (69.2%) were preceded by reflux episodes (55 acid, 1 non-acid). In 5 patients (38.5%), awakenings were significantly associated with reflux.
CONCLUSION
The data suggest that acid GER causes sleep interruptions in obese children who have symptoms of snoring or restless sleep and without evidence of OSA.

Keyword

Gastroesophageal reflux; Besity; Sleep wake disorders; Child; Electric impedance; Obstructive sleep apnea

MeSH Terms

Arousal
Child*
Cystic Fibrosis
Electric Impedance
Esophageal pH Monitoring
Fundoplication
Gastroesophageal Reflux*
Humans
Infant
Polysomnography
Sleep Apnea Syndromes
Sleep Apnea, Obstructive
Snoring*

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