The effect of laryngopharyngeal reflux on arousal in patients with obstructive sleep apnea

Abstract

Background

Laryngopharyngeal reflux (LPR) may be associated with the severity of obstructive sleep apnea (OSA). However, it is unknown whether LPR may be associated with arousal.

Objective

To clarify the effect of LPR on arousal in OSA.

Methods

This study included 120 OSA patients. The correlations between LPR scores and arousal index (ArI) were analyzed. Finally, to further clarify the effect of LPR on ArI, we analyzed the correlations between respiratory event-related arousal index (BERAI), leg-movement-related arousal index (LMRAI), snore-related arousal index (SRAI), spontaneous arousal index (SAI), and RSI score.

Results

Partial correlation analysis showed that the RSI score was positively correlated with ArI (p = .000), mainly correlated with BERAI and SAI (r = 0.422, p = .000; r = 0.212, p = .020). While controlling for apnea-hypopnea index (AHI), the RSI score was still positively correlated with ArI (p = .002), mainly correlated with BERAI and SAI (r = 0.252, p = .006; r = 0.200, p = .029).

Conclusions and significance

The effect of LPR symptoms on arousal in OSA exists. The more severe the LPR was, the more frequent the arousal in OSA patients was. Thereinto, respiratory event-related arousal and spontaneous arousal were the most obvious.

Chinese Abstract

背景：喉咽反流（LPR）可能与阻塞性睡眠呼吸暂停 (OSA)的严重程度有关。然而, 尚不清楚 LPR 是否可能与醒觉有关。

目的：阐明 LPR 对 OSA患者醒觉的影响。

方法：本研究包括 120 名 OSA 患者。 对LPR评分与醒觉指数（ArI）之间的相关性进行了分析。最后, 为了进一步阐明 LPR 对 ArI 的影响, 我们分析了呼吸事件相关醒觉指数 (BERAI)、腿动相关醒觉指数(LMRAI)、打鼾相关醒觉指数 (SRAI)、自发醒觉指数 (SAI) 和 RSI 评分之间的相关性。。

结果：偏相关分析显示, RSI评分与ArI呈正相关(p = .000), 主要与 BERAI 和 SAI 相关 (r =0.422, p = .000; r = 0.212, p = .020)。在控制呼吸暂停低通气指数 (AHI) 的同时, RSI 评分仍与 ArI 呈正相关 (p = .002), 主要与 BERAI 和 SAI 相关（r = 0.252, p = 0.006；r = 0.200, p = 0.029）。

结论与意义：LPR 症状对 OSA患者醒觉的影响是存在的。LPR越严重, OSA 患者的醒觉越频繁。其中, 呼吸事件相关醒觉和自发醒觉最为明显。

Keywords:

• Obstructive sleep apnea
• laryngopharyngeal reflux
• arousal

Disclosure statement

No potential conflict of interest was reported by the author(s).