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.

Remy Thierry
Founder of Sleep Apnea Guide

Comments for Acid reflux and sleep apnea?

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Aug 30, 2011
Rating
starstarstarstarstar 		sleep apnea causes me to belch
by: RODNEY

NODOUBT SLEEP APNEA CAUSES STOMACH UPSETS ..MY CPAP DIDNT OPERATE FOR TWO WEEKS ,,I HAD GAS ,,BELCHING ,BURPING UNTILL CPAP WORKING AGAIN ,,,IT VANISHED IN A WEEK OF REUSING CPAP.
Feb 05, 2014
Rating
starstarstarstarstar 		gerd v sleep apnea
by: Anonymous

Had worsening GERD issues for a couple years, would wake up choking on reflux. Diagnosed with sleep apnea for falling asleep in the day and driving.

All my gerd issues disappeared when put on the CPAP machine and have not had one episode since. Like a miracle cure for nearly all my ailments.

The sleep study showed 500 "events" in a 523 minute night. The doctors will not even suggest it, but you should if you have the problem!!!!!! Take charge of your own healthcare!
Feb 08, 2016
Rating
starstarstarstarstar 		Love my Cpap
by: Anonymous

I am absolutely convinced that my Cpap machine has nearly cured my severe acid reflux problems. I was taking Prilosec every night at bedtime and still experienced some degree of reflux at night.

Was considering taking two pills a day, morning and night. I discovered about a year ago that I had severe sleep apnea and now use a CPAP machine.

After several months using the machine, I realized I wasn't having any reflux issues at night and stopped taking the Prilosec. I do occasionally have some issues during the day but rarely at night while using the machine.

I can't wait to let my doctor know of my results and hope that he doesn't dismiss my discovery. Just in the evening news, it was reported that studies are showing that there is an increased risk of liver damage with people who use antacids on a regular basis.

I am thrilled that my CPAP works for both My apnea and reflux.
Jan 20, 2018
Rating
starstarstarstarstar 		No More Reflux
by: Anonymous

I have had severe GERD for many years. Making my life a misery. Sometimes the acid would come up in my sleep, go down the windpipe and I would spend the next 2 hours or so trying to get that super strong acid out of my lungs.

Embarrassing when staying over at someone's place. I tried every type of antacid plus a daily somac but they only provided minor relief. I bought a CPAP machine and the first night I used it I was reflux free.

After a few nights, I was thinking that my CPAP might be somehow preventing reflux. I didn't say anything to my wife as I thought it was just coincidence but sure enough, I now sleep reflux free.

So not only did the machine improve my apneas it stopped my reflux. I can eat anything now without a worry. The big bonus for the wife is I don't snore anymore. I wish I knew about this years ago. I think my doctor should've known.
Aug 09, 2020
Rating
starstarstarstarstar 		CPAP and Sleep Apnea
by: Privatepilot

I had severe acid reflux. Waking up instantly when my lungs became flooded with stomach acid. I also found out after many years of that, that I had sleep apnea. I was prescribed a CPAP and my acid reflux or GERD instantly went away! That was 8 years ago. But if you think about it, it makes total sense. The pressure and an open esophagus keeps the acid where it belongs. Your automatic breathing during sleep is no longer fighting a blocked esophagus where negative pressure from trying to breathe can pull up acid from the stomach. I am totally and completely satisfied with my CPAP therapy. I believe it saved my life. And, my blood pressure has come down. Just telling you what worked for me.

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