No Significant Association Between Laryngopharyngeal Reflux and Obstructive Sleep Apnea

What can be learned about laryngopharyngeal reflux (LPR) and the potential association between the presence of LPR symptoms and obstructive sleep apnea (OSA)?

BOTTOM LINE

There is no statistically significant association between LPR and OSA; age and smoking, but not body mass index, are associated with LPR.

BACKGROUND: LPR and OSA are common conditions that unfavorably impact quality of life. Although there has been discussion in the literature on LPR and OSA interaction, and although they share risk factors and coexist in the same population, a clear causal relationship between the conditions has yet to be established.

STUDY DESIGN: Cross-sectional study.

SETTING: Department of Otorhinolaryngology–Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil.

SYNOPSIS: Researchers enrolled 701 volunteers from an initial sample of 712 individuals drawn from the eight-year follow-up of a 2007 population-based epidemiological survey. Volunteers completed the Reflux Symptom Index (RSI), Epworth Sleepiness Scale (ESS), WHOQOL-Bref quality of life scale, and Pittsburgh Sleep Quality Index (PSQI). All underwent an overnight sleep study. LPR presence was determined by the RSI symptom questionnaire score. Volunteers were then stratified into two groups—LPR (RSI >13) and non-LPR—and then arranged into individuals with or without OSA. The overall LPR prevalence was 17%, whereas OSA was present in 38.5% of the overall sample. Advanced age, smoking, higher ESS and PSQI scores, and worse quality of life—but not, unlike OSA, body mass index—were associated with LPR presence. LPR prevalence in subjects with OSA was 45.4%; there was no statistically significant association between LPR and OSA, however. In participants with LPR and OSA, quality of life and sleep measures were significantly worse. Study limitations included not excluding the use of proton pump inhibitors or H2 blockers in subjects, which could underestimate the prevalence of LPR in the sample.

CITATION: Campanholo MAT, Caparroz FA, Vidigal TA, et al. Assessment of laryngopharyngeal reflux and obstructive sleep apnea: a population-based study. Laryngoscope. 2022;132:1877–1882.