الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
 |  | from | 95 |  |  |
| | | from | 95 | | |
Abstract
It has been supposed that obstructive sleep apnea syndrome (OSAS) may predispose patients to the development of nocturnal gastroesophageal reflux disease (GERD) because apneic episodes are associated with increased arousal, movements, and transdiaphragmatic pressure and low intrathoracic pressure (kerr et al., 1992).
This study was conducted on 50 patients.They were admitted in sleep laboratory, Chest Department, Mansoura University Hospitals then all the patients underwent a 24hour PH monitoring in the gastrointestinal surgery center, mansoura university Hospitals in the period from January 2009 to July 2010.
The aim of this work was to determine the frequency of GERD in patients with OSAS and to determine the relationship between OSAS severity and GERD severity.
The following were done for all patients:
Thorough history taking physical examination, ENT examination, estimation of Body Mass Index (BMI), plain chest X- ray (postero-anterior view), diagnostic polysomonography and 24 hour PH monitoring to determine the presence of GERD
This study reavled the following:
• This prospective study comprised 30 patients with OSAS and 20 controls (without OSAS). The two groups were age, BMI and sex matched (p= 0.426, 0.095 and 0.470 respectively)
• The heartburn and regurgitation were significantly higher in patients with OSAS as compared to controls (p= 0.005 and 0.035 respectively )while dysphagia showed no significant difference( p= 0.145).
• The DeMeester score was significantly higher in patients with OSAS versus controls (p=0.009) ,also all components of DeMeester score (% time pH < 4 in supine position, % time pH < 4 in upright position, total % time pH < 4, number of episodes pH < 4, number of episodes > 5 min, longest episode) were significantly higher in patients with OSAS versus controls ( p=0.003,0.009,0.009, 0.019 , 0.009, 0.007 respectively
• There were significantly higher frequency of GERD in patients with OSAS versus controls (40% versus 10% p=0.021)
• Heartburn and regurgitation in OSAS patients with GERD were significantly higher than OSAS patients without GERD (p< o.oo1 for both )while the dysphagia showed no significant difference p= 0.320
• The OSAS symptoms (snoring , excessive daytime sleepiness, nocturnal chocking) in OSAS patients with GERD were significantly higher than OSAS patients without GERD (p=0.025,0.003,0.025 respectively)
• The % time in snoring in OSAS patients with GERD were significant higher than OSAS patients without GERD.
• The AHI in OSAS patients with GERD was significant higher than OSAS patients without GERD (37.58 ± 4.06 versus 33.50 ± 5.23 . P = 0.023).
• The arousal index was significantly higher and sleep efficiency was significantly lower in OSAS patients with GERD versus OSAS patients without GERD (P < 0.001 for both).
• The severity of hypoxemia (% TST SoaO2 < 90%) showed significantly positive correlation with severity of GERD (De Mesteer Score) p<0.001 .
• The severity of OSAS (AHI) showed no significant correlation with severity of GERD (De Mesteer Score) p=0.076.