9899Wasilewska J, Kaczmarski MRoczniki Akademii Medycznej w Bialymstoku Vol. 49, 2004 Annales Academiae Medicae BialostocensisSleep-related breathing disorders in small children with nocturnal acid gastro-oesophageal refluxSleep-related breathing disorders in small childrenwith nocturnal acid gastro-oesophageal refluxWasilewska J, Kaczmarski MIII Department of Pediatrics, Medical University of Bialystok, PolandAbstractAHI= 4.99/h 3.12 in children without nocturnal GER.We found no differences between the groups in saturationPurpose: Coincidence of gastroesophageal reflux disease< 90% time during sleep.with obstructive sleep apnea/ hypopnea syndrome has beenConclusions: The study confirms coincidence of noc-discussed in recent years. Treatment with nasal continuousturnal gastroesophageal reflux and sleep-related breathingpositive airway pressure (nCPAP) reduces gastroesophagealdisorders in children. Higher number of apnea / hypopneareflux (GER) in adult patients with obstructive sleep apneaduring REM sleep was found in children with nocturnal(OSA). Moreover, treatment of gastroesophageal reflux withgastroesophageal reflux.omeprazole can reduce the severity of obstructive sleep inselected individuals. The aim of the study was to test thehypothesis that gastroesophageal reflux does not influenceKey words: sleep apnea, gastroesophageal reflux disease,sleep quality and breathing pattern during sleep in chil-ALTE, SIDS, polysomnography.dren.Abbreviations:Material and methods: 24 children (14 boys, 10 girls,aged 2 months-3 years) with sleep disturbances indicat-ALTE Apparent Life Threatening Eventing GER were studied. Standard polysomnography withCI confidence intervalparallel recording of 24-h oesophageal monitoring wasFRT Fractional reflux timeperformed. Apnea/ hypopnea index (AHI) in active/REMnGER nocturnal gastroesophageal refluxsleep and quiet/NREM sleep was compared between noc-OSAHS obstructive sleep apnea/hypopnea syndrometurnal acid GER children (13 children; 7 boys, 6 girls;SaO2 arterial oxygen saturationaged 1.280.95y; FRT-18.6311.83%) and nocturnalSIDS Sudden Infant Death Syndromeacid GER- free controls (11 children; 7 boys, 4 girls; agedTST Total Sleep Time.1.640.97y; FRT- 2.93 2.08%). Exclusion criteria were:1. laboratory signs of infection ( OB, CRP, 2-globulin);Introduction2. clinical symptoms of infection in the respiratory tract, thealimentary tract or in the urinary tract.Results: In children with nocturnal GER higher inci-Coincidence of gastroesophageal reflux disease withdence of obstructive apnea/hypopnea during REM sleepobstructive sleep apnea/ hypopnea syndrome (OSAHS) haswas found: AHI =23.35/h19.1; (CI 95%11.81-34.89) vsbeen discussed in recent years [1-3]. Obstructive sleep apneamay predispose to nocturnal GER by lowering intrathoracicpressure and increasing arousal and movement frequency.ADDRESS FOR CORRESPONDENCE:Nasal continuous positive airway pressure (nCPAP) can correctJolanta Wasilewska M.D.III Department of Pediatricsthese predisposing factors and may be an effective form ofMedical University of Bialystokantireflux therapy leading to reduce GER in adult patients withul. Waszyngtona 17;OSAHS [4-6]. Moreover, treatment of gastroesophageal reflux15-274 Bialystok, PolandFax: +48 85 742 38 41with omeprazole can reduce the severity of obstructive sleep ine-mail: jolanta@amb.edu.plselected individuals [2].The role of gastroesophageal reflux in apnea /breathingReceived 30.06.2004 Accepted 30.06.2004 9899Wasilewska J, Kaczmarski MSleep-related breathing disorders in small children with nocturnal acid gastro-oesophageal refluxTable 1. Population characteristics and polysomnographic findingsGroup IGroup IInGER (+)nGER (-) pn13 11 nsAge (range, y)0.08 -2.90.16 -3.08(Mean)1.280.951.640.97(CI 95%)(0.71 -1.85)(0.98 -2.29) nsMale, n (% )7 (53.8) 7 (63.6) nsBody weight >95% 0 0 nsTotal recording time (min) 1 32443 1287 39 nsTotal sleep time (TST) (min) 698 72 591 84 nsFractional Reflux Time (FRT) (%)18.6311.832.932.08(CI 95%)(11.47 -25.78)(1.53 -4.33) p