Abstract
Polysomnography and esophageal pH studies were conducted in 13 patients with an aperistaltic esophagus; seven of these had scleroderma and six were patients treated for achalasia. The percentage total time of pH <4.0 when recumbent exceeded 30% for both groups. There was a total of 51 reflux events for both groups. There were 22 reflux events recorded for both groups that were less than 5 min in length and 29 events greater than 5 min. In 26 of 32 (81%) instances, patients either began awake and went to sleep during a reflux event or did not awake during a reflux event. Only six of 32 (19%) reflux events caused sleep disruption. We conclude that even the severe reflux demonstrated in this subset of patients does not always disrupt sleep. Patients may have severe prolonged reflux and not arouse.
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References
Johnson LF, DeMeester TR: Twenty-four-hour pH monitoring of the distal esophagus. Am J Gastroenterol 62:325–332, 1974
DeMeester TR, Johnson LF, Joseph GJ, Toscano MS, Hall AW, Skinner DB: Patterns of gastroesophageal reflux in health and disease. Ann Surg 184:459–470, 1976
Shoenut JP, Kerr P, Micflikier AB, Yamashiro Y, Kryger MH: The effect of nasal CPAP on nocturnal reflux in patients with aperistaltic esophagus. Chest 106:738–741, 1994
Freidin N, Fisher MJ, Taylor W, Boyd D, Surratt P, McCallum RW, Mittal RK: Sleep and nocturnal acid reflux in normal subjects and patients with reflux oesophagitis. Gut 32:1275–1279, 1991
Castiglione F, Emde C, Armstrong D, Schneider C, Baverfeind P, Stacher G, Blum AL: Nocturnal oesophageal motor activity is dependent on sleep stage. Gut 34:1653–1659, 1993
Kerr P, Shoenut JP, Millar T, Buckle P, Kryger MH: Nasal CPAP reduces gastroesophageal reflux in obstructive sleep apnea syndrome. Chest 101:1539–1544, 1992
Yarze JC, Varge JV, Stampfl D, Castell DO, Jimenez SA: Esophageal function in systemic sclerosis: A prospective evaluation of motility and acid reflux in 36 patients. Am J Gastroenterol 88:870–876, 1993
Shoenut JP, Wieler JA, Micflikier AB: The extent and pattern of gastro-oesophageal reflux in patients with scleroderma oesophagus: The effect of low-dose omeprazole. Aliment Pharmacol Ther 7:509–513, 1993
Thomson D, Shoenut JP, Trenholm BG, Teskey JM: Reflux patterns following limited myotomy without fundoplication for achalasia. Ann Thorac Surg 43:550–553, 1987
Shoenut JP, Trenholm BG, Micflikier AB, Teskey JM: Reflux patterns in patients with achalasia without operation. Ann Thorac Surg 45:303–305, 1988
Shoenut JP, Micflikier AB, Yaffe CS, Den Boer B, Teskey JM: Reflux in untreated achalasia patients. J Clin Gastroenterol 20:6–11, 1995
Howard PJ, Maher L, Pryde A, Cameron EWJ, Heading RC: Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh. Gut 33:1011–1015, 1992
Orr WC, Robinson MG, Johnson LF: Acid clearance during sleep in the pathogenesis of reflux esophagitis. Dig Dis Sci 26:423–427, 1981
Orr WC, Johnson LF, Robinson MG: Effect of sleep on swallowing, esophageal peristalsis, and acid clearance. Gastroenterology 86:814–819, 1984
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This paper was presented in part at the AGA meeting, San Diego, California, 1995.
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Shoenut, J.P., Yamashiro, Y., Orr, W.C. et al. Effect of severe gastroesophageal reflux on sleep stage in patients with aperistaltic esophagus. Digest Dis Sci 41, 372–376 (1996). https://doi.org/10.1007/BF02093831
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DOI: https://doi.org/10.1007/BF02093831