Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Laryngopharyngeal Reflux in Sleep-Disordered Breathing Patients

Document Type : Original

Authors
Elvie Zulka Kautzia Rachmawati 1
Retno Sulistyo Wardani 1
Rahmanofa Yunizaf 1
Saptawati Bardosono 2
Fikri Mirza Putranto 3
Niken Ageng Rizki 1
Nabilla Calista 1
Susyana Tamin 1
1 Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hopsital, Jakarta, Indonesia.
2 Department Nutrition, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
3 Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine Universitas Indonesia – Universitas Indonesia Hospital, Depok, Indonesia.
10.22038/ijorl.2022.57515.2991
Abstract
Introduction:
Our study aims to evaluate the distribution of laryngopharyngeal reflux (LPR) in patients with sleep-disordered breathing (SDB) via the Reflux Symptom Index (RSI) and to describe the sleep architecture in SDB patients with and without LPR.
Materials and Methods:
A cross-sectional, descriptive study was conducted. Patients with SDB were identified via the Epworth Sleepiness Scale (ESS) and STOP-BANG questionnaire; they were then screened with the RSI and physical examination for LPR. PSG was performed to evaluate obstructive sleep apnea (OSA).
Results:
Of 45 patients, 15 were scored as having LPR via the RSI. Utilizing the Respiratory Disturbance Index (RDI), patients were further classified into four groups: 9 non-LPR with non-OSA SDB, 21 non-LPR with OSA, 4 LPR with non-OSA SDB, and 11 LPR with OSA. The prevalence of LPR was 30.8% in the non-OSA SDB group and 34.4% in the OSA group. All SDB parameters in both groups were similar. SDB patients with high body mass index tended to have LPR and/or OSA. Average ESS scores in the four groups suggested excessive daytime sleepiness, and patients with LPR had higher ESS scores. Regardless of LPR status, SDB patients had a lower percentage of REM sleep and a higher percentage of light sleep.
Conclusions:
The incidence of LPR in OSA patients was similar in non-OSA SDB patients. REM sleep percentage decreased in the four groups, with the non-OSA SDB group having the lowest percentage of REM sleep; light sleep percentage increased in the four groups, with the OSA group having the highest percentage of light sleep.
Keywords
Apnea-Hypopnea Index
Laryngopharyngeal Reflux
Nasolaryngopharyngeal Endoscopy
Obstructive Sleep Apnea
Reflux Symptom Index
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Iranian Journal of Otorhinolaryngology
Volume 34, Issue 6
November and December 2022
Pages 303-310