Interaction of sleep disturbances and gastroesophageal reflux in chronic laryngitis
| Autor: | Bernd Sanner, Hans-Joachim Radü, Johannes Heimbucher, Berthold Rawert, Helmut Teschler, Konermann M |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Adolescent Polysomnography medicine.medical_treatment Laryngitis Helicobacter Infections Positive-Pressure Respiration Gastroscopy Respiratory disturbance index medicine Humans Continuous positive airway pressure Reflux esophagitis Esophagitis Peptic Omeprazole Aged Sleep Apnea Obstructive Helicobacter pylori Laryngoscopy medicine.diagnostic_test business.industry Snoring Reflux Middle Aged Anti-Ulcer Agents medicine.disease Obstructive sleep apnea Otorhinolaryngology Anesthesia Chronic Disease Female Esophagoscopy business Follow-Up Studies medicine.drug |
| Zdroj: | American Journal of Otolaryngology. 23:20-26 |
| ISSN: | 0196-0709 |
| DOI: | 10.1053/ajot.2002.28775 |
| Popis: | Background: A considerable percentage of patients with reflux laryngitis do not respond to conventional treatment with proton pump inhibitors or prokinetics. At the present time, the reasons for this are not well known. Purpose: To investigate whether nocturnal reflux associated with sleep-related respiratory disorders is the cause of refractory laryngitis. Method: The data from 227 patients (133 women, ages 18 to 75 years, body mass index 17.4 to 38.3, mean 32.1 kg/m2) with LG were analyzed retrospectively. All received laryngoscopy and gastroscopy. All patients initially received 40- to 80 mg omeprazole and underwent a follow-up laryngoscopy after 6 weeks. Of the patients, 202 showed a clear improvement, whereas 25 (11.1%) did not. All underwent 24-hour pH monitoring and cardiorespiratory polysomnography. Results: All of the patients showed laryngoscopic signs of LG. Of the patients, 102 (45%) had a hiatal hernia and 53 (28%) suffered from reflux esophagitis. Forty-two patients (19%) were found to have Helicobacter pylori in the stomach. Among the 25 patients who failed to respond to omeprazole, pH monitoring showed nocturnal acid reflux in 15 (60%). Twenty-four patients (96%) showed a sleep-related respiratory disturbance manifesting as pathologic snoring (16 patients) or obstructive sleep apnea (8 patients, respiratory disturbance index [RDI] 11 to 33, mean 16.3/h). All received nasal continuous positive airway pressure (nCPAP) treatment, 16 with constant mask pressure (4 to 12, mean, 5.6 mbar) and 8 with autoadjusting pressure. One patient abandoned treatment; the other 23 showed clear subjective and objective improvement after 3 months of treatment. Conclusions: Even without pH monitoring evidence of nocturnal reflux, refractory LG is very often associated with sleep-related respiratory disorders and responds well to nCPAP treatment. Prospective studies are needed to clarify the details of this association. (Am J Otolaryngol 2002;23:20-26. Copyright © 2002 by W.B. Saunders Company) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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