Non-acid reflux and sleep apnea: the importance of drug induced sleep endoscopy

Background: We present the first case of a patient with obstructive sleep apnea syndrome (OSA), where drug induced sleep endoscopy was helpful to suspect a non-acid reflux disease and showed an improvement in a swollen epiglottis after treatment. Patient ameliorated significantly his disease only wi...

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Detalhes bibliográficos
Autores: O’Connor-Reina, C. (Carlos)|||/items/5f02abf5-9355-4cf9-868a-f6eb1df7b4d7, Garcia, J.M.I. (José Maria Ignacio)|||/items/0e7c19a9-d9b7-4824-a139-e04237c4bf72, Baptista-Jardin, P.M. (Peter Michael)|||/items/66ecbc41-d708-4b43-a527-b733813d5195, Garcia-Iriarte, M.T. (Maria Teresa)|||/items/897c4487-cc22-45db-9334-9e92d937055f, Casado-Alba, C. (Carlos)|||/items/a58e32a1-1033-4a59-990a-34c89f88c5d6, Perona, M. (Monica)|||/items/6d0c06f2-d7ca-4eff-b205-a11463038de2, Borrmann, P.F. (Paz Francisca)|||/items/d2f1acf1-fbe9-4ed9-9216-1ec7a11d1d91, Rodriguez-Alcala, L. (Laura)|||/items/17636c6b-a213-43dd-89b9-a9d7b2a03dc5, Plaza, G. (Guillermo)|||/items/769de495-2430-40c5-b0c0-9739120b7868
Formato: artículo
Fecha de publicación:2021
País:España
Recursos:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/111844
Acesso em linha:https://hdl.handle.net/10171/111844
Access Level:acceso abierto
Palavra-chave:Nonacid reflux disease
Multichannel impedanciometry
Epiglottis
Continuous positive airway pressure
Drug-induced sleep endoscopy
Obstructive sleep apnea
Descrição
Resumo:Background: We present the first case of a patient with obstructive sleep apnea syndrome (OSA), where drug induced sleep endoscopy was helpful to suspect a non-acid reflux disease and showed an improvement in a swollen epiglottis after treatment. Patient ameliorated significantly his disease only with medical therapy. Case presentation: A 54-year-old man without significant anatomical findings with obstructive sleep apnea syndrome and non-acid gastroesophageal reflux disease (GERD) disease whose Apnea- hypopnea index (AHI) was significantly reduced with the intake of 500 mg of sodium alginate twice a day for 6 months. Conventional digestive tests such as esophagoscopy and simple- and double-channel 24-h pH-metry suggested mild GERD. Conventional proton-pump inhibitor treatment with pantoprazole (40 mg daily) was started without any improvement in his sleep. Multichannel intraluminal 24-h impedanciometry indicated the presence of severe pathological GER of gaseous origin. The patient's AHI decreased from 25.3 at baseline to 8 after treatment with sodium alginate. A drug-induced sleep endoscopy study showed the changes before and after this treatment and was helpful for the diagnosis. Conclusions: Thus, medical treatment can be a therapeutic option in some patients with OSA. Multichannel 24-h impedanciometry should be performed when nonacid GERD is suspected.