Association Between Non-erosive Reflux Disease and High Risk of Obstructive Sleep Apnea in Korean Population

You, Chan Ran; Oh, Jung Hwan; Seo, Mi Kyoung; Lee, Hye Yeon; Joo, Hyonsoo; Jung, Sung Hoon; Lee, Sang Haak; Choi, Myung-Gyu

doi:10.5056/jnm.2014.20.2.197

Cited by 21 publications

(25 citation statements)

References 31 publications

(9 reference statements)

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“…Sleep duration and insomnia may be additional factors affecting the relationship of OSA to sleepiness [6,9]. There is also increasing evidence that medical conditions that often coexist with OSA, such as CRS, anxiety, depression, PTSD and GERD, are associated with sleep complaints [11,12,13,14,15,16,17] and may confound the relationship between OSA and sleep-related quality of life outcomes. The independent contribution of each of these conditions to sleep-related complaints and the associated quality of life has not been closely examined.…”

Section: Introductionmentioning

confidence: 99%

The Association between Health Conditions in World Trade Center Responders and Sleep-Related Quality of Life and Sleep Complaints

Ayappa

Chen

Bagchi

et al. 2019

IJERPH

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Background: World Trade Center (WTC) dust-exposed subjects have multiple comorbidities that affect sleep. These include obstructive sleep apnea (OSA), chronic rhinosinusitis (CRS), gastroesophageal-reflux disorder (GERD) and post-traumatic stress disorder (PTSD). We examined the impact of these conditions to sleep-related outcomes. Methods: Demographics, co-morbidities and symptoms were obtained from 626 WTC (109F/517M), 33–87years, BMI = 29.96 ± 5.53 kg/m2) subjects. OSA diagnosis was from a 2-night home sleep test (ARESTM). Subjective sleep quality, sleep-related quality of life (QOL, Functional Outcomes of Sleep Questionnaire), excessive daytime sleepiness (Epworth Sleepiness Scale), sleep duration and sleep onset and maintenance complaints were assessed. Results: Poor sleep quality and complaints were reported by 19–70% of subjects and average sleep duration was 6.4 h. 74.8% of subjects had OSA. OSA diagnosis/severity was not associated with any sleep-related outcomes. Sleep duration was lower in subjects with all conditions (p < 0.05) except OSA. CRS was a significant risk factor for poor sleep-related QOL, sleepiness, sleep quality and insomnia; PTSD for poor sleep-related QOL and insomnia; GERD for poor sleep quality. These associations remained significant after adjustment for, age, BMI, gender, sleep duration and other comorbidities. Conclusions: Sleep complaints are common and related to several health conditions seen in WTC responders. Initial interventions in symptomatic patients with both OSA and comorbid conditions may need to be directed at sleep duration, insomnia or the comorbid condition itself, in combination with intervention for OSA.

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Section: Introductionmentioning

confidence: 99%

The Association between Health Conditions in World Trade Center Responders and Sleep-Related Quality of Life and Sleep Complaints

Ayappa

Chen

Bagchi

et al. 2019

IJERPH

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“…1,8,16,[93][94][95] Whether extra-esophageal reflux symptoms are truly related to esophageal reflux remains controversial. A recent study has shown that the presence of reflux symptoms is related to significantly higher levels of TRPV1, PAR2, and IL-8.…”

Section: Symptomsmentioning

confidence: 99%

Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

125

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It is important to understand sex and gender-related differences in gastroesophageal reflux disease (GERD) because gender-related biologic factors might lead to better prevention and therapy. Non-erosive reflux disease (NERD) affects more women than men. GERD symptoms are more frequent in patients with NERD than in those with reflux esophagitis. However, men suffer pathologic diseases such as reflux esophagitis, Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) more frequently than women. The prevalence of reflux esophagitis is significantly increased with age in women, especially after their 50s. The mean age of EAC incidence in women is higher than in men, suggesting a role of estrogen in delaying the onset of BE and EAC. In a chronic rat reflux esophagitis model, nitric oxide was found to be an aggravating factor of esophageal injury in a male-predominant way. In addition, the expression of esophageal occludin, a tight junction protein that plays an important role in the esophageal defense mechanism, was up-regulated in women. This explains the male predominance of reflux esophagitis and delayed incidence of BE or EAC in women. Moreover, the symptoms such as heartburn, regurgitation, and extra-esophageal symptoms have been more frequently reported by women than by men, suggesting that sex and gender play a role in symptom perception. Differential sensitivity with augmented symptoms in women might have diagnostic and therapeutic influence. Furthermore, recent studies have suggested that hormone replacement therapy has a protective effect against esophageal cancer. However, an anti-inflammatory role of estrogen remains compelling, which means further study is necessary in this area.

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“…The causative relationship between GERD and OSA remains an area of controversy (41). A previous study had shown an association between non-erosive gastroesophageal reflux disease with increased risk of OSA in Korean Population (42). More patients in the GERD group (28.2%) had higher risk for obstructive sleep apnea than healthy controls (20.4%, P = 0.036).…”

Section: Discussionmentioning

confidence: 97%

Ankylosing Spondylitis Is Associated With Risk of New-Onset Obstructive Sleep Apnea: A Nationwide Population-Based Cohort Study

Tsao

Huang

et al. 2019

Front. Med.

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Objectives: Investigating the risk of obstructive sleep apnea(OSA) among ankylosing spondylitis (AS) patients based on administrative healthcare databases.Methods: We conducted a nationwide cohort study by using the Taiwan National Health Insurance Research Database with 1997–2013 claim records. The AS cohort included 2,210 patients who were newly diagnosed between 2003 and 2013. Randomly selected non-AS controls were matched at a 1:4 ratio. The endpoint was set as OSA occurrence or the end of 2013. Cumulative incidences, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated after adjusting for age, gender, comorbidities, and co-medication. Multivariate analyses were performed using the Cox proportional hazards model. Due to the violation of the proportionality assumption, landmark analysis was conducted to explore the risk of OSA during specific follow-up periods.Results: The adjusted HR (aHR) of OSA in the AS group was 2.826 (95% C.I. = 1.727–4.625) compared to the control group. On landmark analysis, aHR was 7.919 (95% C.I. = 3.169–19.792) for the AS group 0–24 months from the index date and decreased to 1.816 (95% C.I. = 0.944–3.494) at ≥ 24 months from the index date. The increased risks of OSA in the AS group compared to the control group were found for both males and females (aHRs were 4.533 and 2.672). On age-stratified analysis, a significant risk only for the 40–59 age group with aHR of 3.913 (95% C.I. = 1.890–8.102).Conclusions: A higher risk of developing OSA was found among newly diagnosed AS cohort during the maximum 11-year follow-up period, especially within 2 years after newly diagnosed AS and in the 40–59 age group.

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Association Between Non-erosive Reflux Disease and High Risk of Obstructive Sleep Apnea in Korean Population

Cited by 21 publications

References 31 publications

The Association between Health Conditions in World Trade Center Responders and Sleep-Related Quality of Life and Sleep Complaints

The Association between Health Conditions in World Trade Center Responders and Sleep-Related Quality of Life and Sleep Complaints

Sex and Gender Differences in Gastroesophageal Reflux Disease

Ankylosing Spondylitis Is Associated With Risk of New-Onset Obstructive Sleep Apnea: A Nationwide Population-Based Cohort Study

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