Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Gastroesophageal Reflux Affects Sleep Quality in Snoring Obese Children

  • Machado, Rodrigo Strehl (Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de Sao Paulo) ;
  • Woodley, Frederick W (Division of Pediatric Gastroenterology, Ohio State University) ;
  • Skaggs, Beth (Department of Pediatrics, Nationwide Children's Hospital) ;
  • Lorenzo, Carlo Di (Division of Pediatric Gastroenterology, Ohio State University) ;
  • Eneli, Ihuoma (Department of Pediatrics, Ohio State University) ;
  • Splaingard, Mark (Department of Pediatrics, Ohio State University) ;
  • Mousa, Hayat (Division of Pediatric Gastroenterology, Ohio State University)
  • Received : 2015.08.11
  • Accepted : 2015.11.28
  • Published : 2016.03.30
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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.

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References

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