Clinical course and cardio-respiratory monitoring of patients with obstructive sleep apnea and gastroesophageal reflux disease


  • V. I. Kryvenko Zaporizhzhia State Medical University, Ukraine,
  • O. A. Svitlytska Zaporizhzhia State Medical University, Ukraine,



obstructive sleep apnea, gastroesophageal reflux disease, cardio-respiratory disorders



Purpose. To study the obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) combined course characteristics based on clinical studies and cardio-respiratory monitoring.

Materials and methods. 125 patients were examined: group I – 31 patients with GERD, group II – 32 patients with OSA, group III – 62 patients with combined OSA and GERD. A cardio-respiratory study, esophagogastroduodenoscopy were performed. The severity of complaints was assessed on the Likert scale, GERD symptoms evaluation – on the F.S.S.G. Patients were questioned on a scale of reactive (RA) and personal (PA) anxiety by Spielberger–Khanin scale. Patients were tested for H. pylori infection by the stool-test.

Results. Patients of group III, compared with patients of group I, showed a significant increase in complaints of reflux feeling (+64.4 %), cough (+41.3 %), heartbeat and feeling of interruptions in the heart (+71.6 %), dysphagia (+16.3 %) (P < 0.05). In group III, the magnitude of the component “reflux symptoms” according to F.S.S.G. was byn 1.5 times, and the component “symptoms of dysphagia” was by 1.7 times more than in group I (P < 0.05). In group III, moderate and severe degree of apnea was observed in patients (71 %), while in group II there were 17 patients (53 %). In patients of group ІІІ, the value of the PA indicator exceeded the analogous parameter in patients of group І by +35.7 % (P < 0.05), Group II – by +80.9 % (P < 0.05). Patients of group III had more severe course of GERD (according to endoscopic signs) (χ2 = 5.125, df = 2, P < 0.05). A significant interaction was determined between the degree of esophagus damage and H. pylori infection, the severity of OSA (respectively, γ = +0.46 and γ = +0.30, P < 0.05). Significant relationships were found between the severity of OSA and the severity of GERD symptoms, the duration of GERD, and H. pylori infection.

Conclusions. Patients with a combined course of OSA and GERD have a mutual burdening syndrome, which worsens the course of two diseases.



Senaratna, C. V., Perret, J. L., Lodge, C. J., Lowe, A. J., Campbell, B. E., Matheson, M. C., Hamilton, G. S., & Dharmage, S. C. (2017). Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Medicine Reviews, 34, 70-81.

Garvey, J. F., Pengo, M. F., Drakatos, P., & Kent, B. D. (2015). Epidemiological aspects of obstructive sleep apnea. Journal of Thoracic Disease, 7(5), 920-929.

Rodrigues, A. P., Pinto, P., Nunes, B., & Bárbara, C. (2017). Obstructive Sleep Apnea: Epidemiology and Portuguese patients profile. Revista Portuguesa de Pneumologia (English Edition), 23(2), 57-61.

Bychkov, M. A., & Yakhnytska, M. M. (2017). Poshyrenist hastroezofahealnoi refliuksnoi khvoroby za danymy endoskopichnykh doslidzhen [Prevalence of gastroesophageal reflux disease according to the results of endoscopic examinations]. Zdobutky klinichnoi i eksperymentalnoi medytsyny, (2), 38 43. [in Ukrainian].

Chen, C.-H., Lin, C.-L., & Kao, C.-H. (2016). Association between gastroesophageal reflux disease and coronary heart disease: A nationwide population-based analysis. Medicine, 95(27), Article e4089.

Sidhwa, F., Moore, A., Alligood, E., & Fisichella, P. M. (2017). Diagnosis and Treatment of the Extraesophageal Manifestations of Gastroesophageal Reflux Disease. Annals of Surgery, 265(1), 63-67.

You, C. R., Oh, J. H., Seo, M., Lee, H. Y., Joo, H., Jung, S. H., Lee, S. H., & Choi, M.-G. (2014). Association Between Non-erosive Reflux Disease and High Risk of Obstructive Sleep Apnea in Korean Population. Journal of Neurogastroenterology and Motility, 20(2), 197-204.

Kapur, V. K., Auckley, D. H., Chowdhuri, S., Kuhlmann, D. C., Mehra, R., Ramar, K., & Harrod, C. G. (2017). Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine, 13(03), 479-504.

Sim, Y. S., Lee, J.-H., Lee, W.-Y., Suh, D. I., Oh, Y.-M., Yoon, J.-S., Lee, J. H., Cho, J. H., Kwon, C. S., & Chang, J. H. (2017). Spirometry and Bronchodilator Test. Tuberculosis and Respiratory Diseases, 80(2), 105-112.

Hungin, A. P. S., Molloy-Bland, M., & Scarpignato, C. (2019). Revisiting Montreal. The American Journal of Gastroenterology, 114(3), 414-421.

Kryvenko, V. I., Pakhomova, S. P., Fedorova, O. P., Kolesnyk, M. Yu., Kachan, I. S., Nepriadkina, I. V., Hrinenko, T. Yu., & Demchenko, A. V. (2015). Formalizovana otsinka stanu khvoroho za dopomohoiu shkal pry osnovnykh vnutrishnikh khvorobakh [Formalized assessment of the patient's condition using scales for major internal diseases]. Zaporizhzhia. [in Ukrainian].

Sandhu, D. S., & Fass, R. (2018). Current Trends in the Management of Gastroesophageal Reflux Disease. Gut and Liver, 12(1), 7-16.

Shepherd, K., & Orr, W. (2016). Mechanism of Gastroesophageal Reflux in Obstructive Sleep Apnea: Airway Obstruction or Obesity? Journal of Clinical Sleep Medicine, 12(01), 87-94.

Bironneau, V., Goupil, F., Ducluzeau, P. H., Le Vaillant, M., Abraham, P., Henni, S., Dubois, S., Paris, A., Priou, P., Meslier, N., Sanguin, C., Trzépizur, W., Andriantsitohaina, R., Martinez, M. C., & Gagnadoux, F. (2017). Association between obstructive sleep apnea severity and endothelial dysfunction in patients with type 2 diabetes. Cardiovascular Diabetology, 16(1), Article 39.

Pinto, J. A., Ribeiro, D. K., Cavallini, A. F., Duarte, C., & Freitas, G. S. (2016). Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study. International Archives of Otorhinolaryngology, 20(2), 145-150.

Karajibani, M., Bakhshipour, A. R., Montazerifar, F., Dashipour, A., Rouhi, S., & Moradpor, M. (2018). Pro-Oxidant and Antioxidant Balance, Anthropometric Parameters, and Nutrient Intakes in Gastro-Esophageal Reflux Disease Patients. Zahedan Journal of Research in Medical Sciences, 20(4), Article e58553.

Palma, J.-A., Iriarte, J., Fernandez, S., Valencia, M., Alegre, M., Artieda, J., & Urrestarazu, E. (2014). Characterizing the phenotypes of obstructive sleep apnea: Clinical, sleep, and autonomic features of obstructive sleep apnea with and without hypoxia. Clinical Neurophysiology, 125(9), 1783-1791.

Hoyos, C. M., Melehan, K. L., Liu, P. Y., Grunstein, R. R., & Phillips, C. L. (2015). Does obstructive sleep apnea cause endothelial dysfunction? A critical review of the literature. Sleep Medicine Reviews, 20, 15-26.

Herasymchuk, N. M. (2018). 8-isoprostane as the main marker of oxidative stress. Zaporozhye Medical Journal, 20(6).

Ponomarenko, L. A., Lykholat, O. A., & Ponomarenko, O. A. (2018). Zminy pokaznykiv okysnoho homeostazu u khvorykh na kyslotozalezhni zakhvoriuvannia pry likuvanni [Changes of indicators of oxidative stress in patients with acid-dependable diseases in treatment]. Medychna ta klinichna khimiia, 20(3), 84-89. [in Ukrainian].

How to Cite

Kryvenko VI, Svitlytska OA. Clinical course and cardio-respiratory monitoring of patients with obstructive sleep apnea and gastroesophageal reflux disease. Zaporozhye Medical Journal [Internet]. 2020Apr.13 [cited 2024Jul.17];22(2). Available from:



Original research