Pediatric Gastroenterology, Hepatology & Nutrition  2016;19(1):12-19

doi:10.5223/pghn.2016.19.1.12

Gastroesophageal Reflux Affects Sleep Quality in Snoring Obese Children.

Rodrigo Strehl MACHADO 1 ; Frederick W WOODLEY ; Beth SKAGGS ; Carlo Di LORENZO ; Ihuoma ENELI ; Mark SPLAINGARD ; Hayat MOUSA

Affiliations

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Keywords

Gastroesophageal reflux; Besity; Sleep wake disorders; Child; Electric impedance; Obstructive sleep apnea

Country

Republic of Korea

Language

English

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.