Acid reflux and sleep apnea?

by Jake Fullington
(Lubbock,TX)

I have terrible sleep apnea and pretty severe acid reflux. Is it possible the reflux is the cause of my sleep apnea? Doctors said my airways looked fine.

Answer

Acid reflux, or GERD (gastroesophageal reflux) is often seen in patients with sleep apnea. One study showed that prior to treatment, 68% of patients with obstructive sleep apnea had episodes of sleep-related GERD, which improved to 48% after treatment with CPAP.

This article could be helpful to understand more.

The problem with GERD and sleep apnea is that the doctors didn't figured out which causes which. A theory is that the struggle to get air in causes a vacuum effect that suctions the stomach and esophageal contents into the throat, causing edema which further narrows the airway.

There's definitely a debate about this theory.

Dr. Jim O'Brien, the President of Talk About Sleep, explained how snoring and apnea episodes can cause acid reflux in patients:

The bottom of the swallowing tube (esophagus) enters the stomach just after it passes through the diaphragm, which is the breathing muscle during REM stage sleep.

Inside the lower end of the esophagus there is a “one-way” valve that prevents any stomach acid or gastric contents from traveling backwards up the esophagus and into our lungs or mouth, by accident. The valve is called the lower esophageal sphincter (LES).

In some patients with either a weak or leaky LES and history of heavy snoring or obstructive apnea, the suction efforts can be so strong that air is sucked out of the stomach, including gastric acid and contents which then can travel up the esophagus and get sucked down into the lungs...not a good thing.

Acid reflux can also be caused by hiatus hernia, so it's not necessary to have sleep apnea. However, if you learn more about the symptoms of sleep apnea and it's side effects, maybe you will discover some similarities with what happens to you now.

Remember, the best way to diagnose sleep apnea is to have a sleep study, not to have inspected for abnormal airways.

Remember that central sleep apnea can also make you stop breathing in sleep, and so can cause GERD. You don't need to have unusual airways to discover if you have central apnea. It all happens in your brain.

So, you could look very normal, and still have sleep apnea. I recommend a sleep study, or an investigation for hiatus hernia.

In the meantime, I would suggest something to help with your acid reflux:

avoid large meals before sleep as they can produce increased gastrointestinal activity that may lead to disrupted sleep.

big meals just before sleep can exacerbate obstructive apnea by preventing diaphragm action, and are often associated with GERD.

meals containing spicy foods are also best avoided before sleep because of their stimulating effects.

CPAP can be useful in patients who have exclusively nocturnal GERD and sleep apnea.

Small meals taken at two- to three-hour intervals during the day may be useful in reducing
gastroesophageal reflux.

weight loss is very helpful for the treatment of gastroesophageal reflux, if the patient is overweight.

I hope it helps. Don't be afraid to comment back.

Some more interesting pages for you to check out:

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Remy
www.sleep-apnea-guide.com

Please remember...what is posted on these forums are our experiences, thoughts and opinions...it is not always 100% accurate.