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KMID : 1038820160190010012
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Pediatric Gastroenterology, Hepatology & Nutrition
2016 Volume.19 No. 1 p.12 ~ p.19
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Gastroesophageal Reflux Affects Sleep Quality in Snoring Obese Children
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Rodrigo Strehl Machado
Frederick W Woodley
Beth Skaggs
Carlo Di Lorenzo
Ihuoma Eneli
Mark Splaingard
Hayat Mousa
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Abstract
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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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KEYWORD
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Gastroesophageal reflux, Besity, Sleep wake disorders, Child, Electric impedance, Obstructive sleep apnea
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