Positive airway pressure treatment affects respiratory symptoms and gastro-oesophageal reflux: the Icelandic Sleep Apnea Cohort Study.


Journal

ERJ open research
ISSN: 2312-0541
Titre abrégé: ERJ Open Res
Pays: England
ID NLM: 101671641

Informations de publication

Date de publication:
Sep 2023
Historique:
received: 12 06 2023
accepted: 24 07 2023
medline: 11 10 2023
pubmed: 11 10 2023
entrez: 11 10 2023
Statut: epublish

Résumé

To study the effect of positive airway pressure (PAP) treatment on nocturnal gastro-oesophageal reflux (nGOR) and respiratory symptoms among clinical obstructive sleep apnoea (OSA) patients. 822 patients newly diagnosed with OSA referred for PAP treatment were recruited. 732 patients had a 2-year follow-up visit with continuous PAP compliance data (366 full PAP users, 366 partial/non-PAP users). They answered questionnaires, including reporting of nGOR, sleep and respiratory symptoms and general health. Patients with nGOR symptoms once a week or more were defined as "with nGOR". Those without nGOR symptoms and nGOR medication were defined as "no nGOR". Others were defined as "possible nGOR". At 2-year follow-up, PAP treatment among full users resulted in decreased nGOR (adjusted OR 0.58, 95% CI 0.40-0.86) and wheezing (adjusted OR 0.56, 95% CI 0.35-0.88) compared with partial/non-PAP users. Decreased nGOR, among both full and partial/non-users of PAP treatment, was associated with a decrease in productive morning cough (adjusted OR 4.70, 95% CI 2.22-9.99) and a decrease in chronic bronchitis (adjusted OR 3.86, 95% CI 1.74-8.58), but not decreased wheezing (adjusted OR 0.90, 95% CI 0.39-2.08). A mediation analysis found that PAP treatment directly led to a decrease in wheezing, not mediated through nGOR. Conversely, PAP treatment decreased productive cough mediated through a decrease in nGOR. In an unselected group of OSA patients, PAP treatment for 2 years was associated with a decrease in nGOR and respiratory symptoms. The PAP treatment itself was associated with less wheezing. A decrease in nGOR through PAP treatment was associated with a decrease in productive cough.

Identifiants

pubmed: 37817868
doi: 10.1183/23120541.00387-2023
pii: 00387-2023
pmc: PMC10561083
pii:
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright ©The authors 2023.

Déclaration de conflit d'intérêts

Conflict of interest: All authors have nothing to disclose.

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Auteurs

Össur Ingi Emilsson (ÖI)

Department of Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Department of Medical Sciences: Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.

Thor Aspelund (T)

Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland.

Christer Janson (C)

Department of Medical Sciences: Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.

Bryndis Benediktsdottir (B)

Department of Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

Sigurdur Juliusson (S)

Department of Otolaryngology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.

Greg Maislin (G)

Division of Sleep Medicine/Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.

Allan I Pack (AI)

Division of Sleep Medicine/Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.

Brendan T Keenan (BT)

Division of Sleep Medicine/Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.

Thorarinn Gislason (T)

Department of Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

Classifications MeSH