الفهرس 
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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. (5)
This study was conducted on 45 subjects. They attended to Chest Department, Menofiya University Hospital, from May 2013 to November 2013 and were diagnosed with polysomnography . They were divided into two group, 30 patients and 15 controls.
The aim of this work was to determine the frequency of GERD among OSAS patients and to assess its response to CPAP treatment for 6 months .
The following were done for all patients:
Thorough history taking, physical examination, ENT examination, estimation of BMI , plain chest X- ray (postero-anterior view), diagnostic polysomonography and upper GI endoscopy to determine the presence of GERD
This study revealed the following:
The two groups of the study were age, BMI and sex matched (p= 0.480, 0.121 and 0.518 respectively)
The heartburn and regurgitation were significantly higher in patients with OSAS as compared to controls (p= 0.015 and 0.048 respectively). Heart burn in patients with OSAS versus controls was 63,3% versus 20% and regurgitation in patients with OSAS versus controls was 40% versus 6.7%, while dysphagia showed no
significant difference ( p= 0.526). Dysphagia in patients with OSAS versus controls was 10 % versus 0.0 % .
There were significantly higher frequency of GERD in patients with OSAS versus controls (43.3% versus 13.3%) ( p= 0.044 ) .
Heartburn and regurgitation in OSAS patients with GERD were significantly higher than OSAS patients without GERD (p= 0.002 and 0.001 respectively). Heartburn in OSAS patients with GERD versus in OSAS patients without GERD was 100% versus 41.2% , regurgitation in OSAS patients with GERD versus OSAS patients without GERD was 76.9% versus 11.8% while the dysphagia showed no significant difference (p= 0.806).
Dysphagia in OSAS patients with GERD versus OSAS patients without GERD was 15.4% versus 5.9% .
The OSAS symptoms (snoring , excessive daytime sleepiness,) in OSAS patients with GERD were significantly higher than OSAS patients without GERD (p=0.025, 0.006 respectively) ). Snoring in OSAS patients with GERD versus in OSAS patients without GERD was 100% versus 70.6% and excessive daytime sleepiness in OSAS patients with GERD versus OSAS patients without GERD was 100% versus 47.1% .
The use of continuous positive airway pressure (CPAP) for 6 months treatment reduced GERD in patients with OSAS from 13 patients to 5 patients(by 61.5%)