Gastroesophageal reflux disease may produce esophageal syndromes, such as heartburn and regurgitation. It is a common clinical presentation with extraesophageal manifestations, such as asthma, arrhythmia, snoring, and sleep disturbance, which could make identifying it more difficult than the usual esophageal symptoms. The aim of this study is to characterize the extraesophageal manifestations in patients with gastroesophageal reflux disease and investigate the effect of laparoscopic Nissen fundoplication. We describe the case of a 38-year-old male patient with a history of sleep disturbance attributable to gastroesophageal reflux disease, which resolved on successful laparoscopic Nissen fundoplication treatment. The long-standing sleep apnea obviously improved after laparoscopic Nissen fundoplication treatment. To our knowledge, this is a rare case of successful laparoscopic Nissen fundoplication treatment of a patient with extraesophageal manifestations induced by gastroesophageal reflux disease. The results indicate an underlying mechanism for extraesophageal manifestations and the success of laparoscopic Nissen fundoplication treatment.Keywords Laparoscopic Nissen fundoplication . Obstructive sleep apnea syndrome . Gastroesophageal reflux disease Case ReportWe report the case of a 38-year-old male patient who had been experiencing acid reflux and heartburn for 10 years, as well as attacks of shortness of breath, stridor, and laryngeal tightness for 6 years. He was otherwise healthy and had no history of smoking, drinking, allergies, or family history of any similar diseases. He received six emergency rescue treatments from a local hospital due to suffocation. We found edema of the throat and laryngospasm when we did incision of trachea at the updated emergency rescue.Laboratory examinations, heart ultrasound, and chest X-ray yielded no abnormalities. Gastroscopy presented reflux esophagitis with Los Angeles grade C and Barrett esophagus. The Helicobacter pylori culture was positive. The Demesster score of 24-hour esophageal pH monitoring was 78.34. It showed severe pathological acid reflux in the distal esophagus. Esophageal manometry indicated that the pressure of lower esophageal sphincter was low. Polysomnography (PSG) found severe nocturnal anoxemia. The patient's apnea hypopnea index (AHI) was 45.7 and the min SpO 2 was 57 %.The patient was diagnosed with gastroesophageal reflux disease (GERD), reflux esophagitis with LA-C, H. pylori (+), Barrett esophagus, and obstructive sleep apnea syndrome (OSAS). He was treated with drugs for GERD, including domperidone, famotidine, and omeprazole. After the chemotherapy, the symptoms, including acid reflux and heartburn, were relieved. However, there were no obvious changes in symptoms such as the attacks of shortness of breath, stridor, laryngeal tightness, and sleep apnea. The repeat PSG found that AHI was 40 and the min SpO 2 was 55 %.