Poll: GERD and Sleep Apnea

[Julie]

I never said "Nobel laureates", but that they had been considered for prizes. Google Lap Chee Tsui, Erwin Gelfand (M.D.) and Wilder Penfield and you'll see that the first two worked in Toronto and the last in Montreal, where I'm from. LCT worked in pediatric genetics (now in H.Kong), IG in pediatric neurology (now in the U.S) and WP founded the Mtl. Neurological Institute and is now deceased ('84). I just got lucky in being at the right places at the right times. I do not have a medical degree, but a BA, though it's interesting that you say you took horticulture, because I taught bonsai at a community college here.

The word "causal" (re folic acid) pretty much implies ... cause, followed by that list of conditions, but it's silly to argue semantics. I am very sure you want the best for your children but I have a personal bias (actually based on another woman a few years ago who really used hers as lab rats to prove her beliefs about alternative meds) about the matter. I never said folates weren't a good thing, possibly for many problems - it was the way that sentence read that got me going, and if they have helped you to feel better, fantastic.

I don't want to fight over anything here, but believe I have as much right as you to express my feelings on topics as they're presented. If it came across as hurtful, I'm very sorry.

[socknitster]

Ok, I get it. I understand where you are coming from. I can understand your worry that someone might use their children that way--the thought of that makes me cringe! But no. I am very, very cautious. And I am not giving my children anything scary. Yes, I am giving my kids this form of folic acid because they have some of the same symptoms as me. Sleep problems, mood problems and muscle fatigue/no stamina.

For example, my older son, just like me, is a thin, active child. He is 6 and in soccer and runs around all the time. Yet he has no stamina. When the kids race he starts out strong and soon flags and comes in last every time. We simply walk for a couple of blocks and he tells me his legs hurt. This is not normal. This is just like me. It scares the hell out of me. I am terrified he will have lifelong health problems. He has already had a brush with sleep apnea, which thankfully was cured with a tonsilectomy. Yet, until recently (with the start of the folic acid) he got up more often than the baby in the middle of the night. Trouble falling asleep, staying asleep and tired all day long. And this is with a very balanced diet. This child counts among his favorite foods broccoli and apples. He eats a good variety of whole grains and fruits/veg and nuts/legumes and lean meats. I am very serious about good diet. He eats very, very little junk. Just enough to give him an occasional taste as a treat so he doesn't feel completely deprived--he knows all the other kids eat that crap every day!

So, not only am I desperate to determine what is wrong with ME, but I have to figure it out for THEM as well. Because whatever it is, it is probably genetic in nature. That is why I'm going to go to the medical geneticist to be tested for the MTHFR gene defect.

I guess I have been telling myself it is just a form of folic acid (recently came off prescription and available over the counter) and as long as its from a reputable source and I give it in age-approriate doses then it should be ok. And since I have seen improvement in all three of us, I would hesitate to discontinue. But maybe I should reevaluate that thinking until I am able to complete the testing. But that may be months away because I have first to find the doctor and then to schedule the appointment and then to wait for test results.

i guess I figured when I tried the folic acid on myself and saw positive results so quickly that I was the guinea pig. Maybe I need to rethink that.

But for now lets agree and say we both have children's best interests at heart and folic acid is important in all kinds of ways.

[Julie]

Oh, it's so obvious how much you love your children - no question about that! Problems (not necessarily with you!) can arise when a parent (or anyone else) get something in their head about what's good, or works for themself, then decides their kids must have the same problem because they read similar 'symptoms' or traits (quite possible of course if they're your kids!) into the children's behaviour, etc., and proceed to 'treat' the children the same way they are treating themselves, all without benefit of proper, qualified medical oversight. And to top it off, the parent may well be a raving hypochondriac to begin with, not have the conditions they believe make them feel sick, or may have other ones they're unaware of (which of course could be negatively affected by whatever they choose to medicate themselves with) that should be addressed, etc. etc. and then visit the whole mess on their children. I am SO not saying that is the case with you, but it's an example of how people can get carried away, projecting their problems onto the kids (it's so common, once you have a 'condition', to then see it in everyone else you meet), when the kids are in fact perfectly fine to begin with, and/or need something quite different. You are obviously intelligent and educated, something that original person I spoke of was not - in fact I believe she was literally psychotic, so it's good to know you're looking at things from all angles. I certainly agree there are many MD's out there, well intentioned, but who are pathetically ignorant about many alternative meds, or natural remedies, and man made ones, but the good ones make a point of keeping up with what's out there, though of course no one doctor can ever be really knowledgable about everything, though if they choose a subspecialty based on one area, like 'sleep doctors' and OSA, they are the ones to look for. I'm quite prepared to believe folates are every bit as miraculous as e.g. aspirin has been found to be, but it's important to stay objective, and to keep pulling back on occasion to look again at the whole picture not only of the meds, but the patient. Anyhow, again I am sorry if I hit the wrong buttons - it was late (here - Atlantic time) last night and I was tired, but feeling righteous, but would hate to have alienated you or anyone else with my 'vitriol' !

[rada]

I was intrigued by the subject heading of GERD and Sleep Apnea though the conversation in this thread lately has been on folates. Anyhow, a quick review of web sites with information on the GERD subject suggests that the relationship can go both ways: GERD to OSA or OSA to GERD. Here's one site http://www.everydayhealth.com/gerd/slee ... -gerd.aspx that makes a plain English explanation -- consistent with what the CPAPtalk participants have been saying in this 2-year dialog and poll on the subject.

[mars]

I was intrigued by the subject heading of GERD and Sleep Apnea though the conversation in this thread lately has been on folates. Anyhow, a quick review of web sites with information on the GERD subject suggests that the relationship can go both ways: GERD to OSA or OSA to GERD. Here's one site http://www.everydayhealth.com/gerd/slee ... -gerd.aspx that makes a plain English explanation -- consistent with what the CPAPtalk participants have been saying in this 2-year dialog and poll on the subject.

Hi Rada

I don't disagree with the consensus of opinion on Gastroesophegal Reflux Disease and Obstructive Sleep Apnea, or most of what you say. But I do have strong reservations about believing any link that says -

Sleep Apnea and GERD

By Madeline Vann, MPH

Sleep apnea is a condition in which breathing frequently stops for a brief period during sleep, so the person wakes up.

For myself, I would stop reading at that point, and check out other sites for the information I wanted.

cheers

Mars

PS - Underlining by me

[Sandra]

Hi, this is my first post (newly diagnosed, waiting for machine)...

I have GERD, been problematic since about a year and a half ago. Put on these meds, then that. Am now on the maximum dose of current meds just to barely control it. In retrospect, my awareness of sleep apnea signs/symptoms have been approximately the same length of time. Very interested in this relationship, will be interesting to see where further studies lead. And hoping, hoping, treatment will help alleviate some of the GERD symptoms and I'll be able to cut back on the meds.

[Physician]

It would be interesting to see if those patients with both GERD + OSA:

1. are overweight
2. are obese
3. have caffeine with 12 hours opf bedtime
4. consume chocolate within four hours of bedtime
5. eat a late dinner
6. smoke cigarettes

and some other parameters

[Julie]

Well, that's an interesting list... for the record, at age 50 I developed what was eventually dx'd on scope as chronic focal gastritis right around menopause, tho' unaware of any reflux, ten yrs prior to dx of OSA, after having (for the first time in my life) gained 30+ lbs in the interim. Now the gastritis could have genetic roots - father died of stomach ca. I quit anything at all with caffeine/chocolate, plus whichever spices, acidic food/drink ended up being problems years ago, though tiny slips have invariably ended up in trouble. It's very hard to lose the extra weight now (which is only in front - I wonder if I don't have an excess of some male hormone, tho' no other signs whatsoever, or low estrogen, but never took HRT). Smoke 1-2 cigarettes daily (not pks) and as a 'grazer' just eat small amts of whatever (fairly well balanced tho') at intervals, no big 'meals'. Also wonder if I've had OSA all my life to some extent - but always having been 'hyper' it's hard to sort out... also wonder if Mono at 25 could have triggered it, tho' Google 'research' is not at all clear of any connection there. I think this is more info than you wanted, but things never go in straight lines so feel some explanation needed at times .

[BlackSpinner]

It would be interesting to see if those patients with both GERD + OSA:

1. are overweight
2. are obese
3. have caffeine with 12 hours opf bedtime
4. consume chocolate within four hours of bedtime
5. eat a late dinner
6. smoke cigarettes

and some other parameters

1 - wasn't over weight when it started,
3- didn't have that much caffiene until the OSA really kicked in,
4 - Not that much chocolate
5 - no late dinner
6- never smoked

Looking back the GERD really started after I had a really bad flu/bronchitis back in 2000 and probably the OSA got a good kick start then too because my blood pressure started acting up at about the same time. Every time I got a flu or cold things got worse.

[socknitster]

It would be interesting to see if those patients with both GERD + OSA:

1. are overweight
2. are obese
3. have caffeine with 12 hours opf bedtime
4. consume chocolate within four hours of bedtime
5. eat a late dinner
6. smoke cigarettes

and some other parameters

I find this list a little insulting. Anyone who takes the time to actively spend time on this board has probably done the research into reflux triggers and tries to avoid them. And once again, its blame the patient! I think if you talk to many of us, you will find that many of us became overweight as a result of the sleep apnea instead of the other way around. I for one was active and slim when all my sleep problems began, leading to extreme fatigue and a more sedentary lifestyle/food cravings. This might not have been a problem if I had lived 200 years ago, but with the abundance of empty calories in todays society, gaining weight is all too easy.


Blackspinner, your case is probably very complex, but you mention getting worse with bouts of illness--illness is very taxing on nutritional stores, especially zinc and magnesium. Add mild nutritional deficiency to the airway irritation of coughs/colds and that could explain your difficulty. I firmly believe that most modern disease is due to lack of nutrition. Our modern agrigulture has removed a lot of important nutrients from the soil without putting it back--food just isn't what it used to be. And so much of the modern american diet is refined, further removing the nutrition. I would make sure you are getting a good multivitamin/multimineral and add some magnesium (not magnesium oxide) to your supplements. And of course, eat well! It might not reverse your condition, but it will improve your overall health and help you resist future infections.

Jen

[SleepingUgly]

I apologize that I can't wade through all these posts.

CPAP helps with GERD. CPAP helps with GERD even in the absence of OSA! (I'm sorry that I don't have the citation at my fingertips, but I cited it here once before).

Gastric acid does not promote transient lower sphincter relaxation. But once the stomach is distended with air through aerophagia, transient lower sphincter relaxation may occur.

[echo]

black spinner, I sympathize too. another thing to consider, given some of the issues you mention, is hypothyroidism. One of the effects is reduced ability to overcome infection. The last two years I had been getting colds/flu/bronchitis/pneumonia on average of once every three months. I bet untreated OSA affects the thyroid too. Hypothyroidism can also cause constipation, which is actually one of my reflux triggers! Best site I've found for good info: http://thyroid.about.com .

One more thought - the quality of our drinking water can affect reflux too. My sister has been having some bad reflux last few years, and every time she travels it goes away. She finally came to the conclusion that it was her tap water(too much chlorine) so she's switching to bottled water to see if that helps. When I went to visit her a couple of months ago, my reflux was very very bad, which I suspected was also due to her water... now she believes me finally. I wonder if the chlorine is killing all the good bacteria in the gut, causing bowel imbalance, and triggering reflux....?

[deerslayer]

yep had esophageal reflux before . elevated head of bed & all that , took ranitadine for it . condition dissapeared with cpap therapy. still take ranitadine to protect stomach from ibuprofin which fortunately have been able to cut way back on *

[asleep@thewheel]

where do you even begin to start with this post and all of the amazing info you all have provided.
All I know at this point in time since I am not a Dr., I just play one on TV is this:

Upon my initial visit to a great allergist at Stanford Anita Carmen Choy, I was brought up to speed with the correlation of OSA and it's byproduct of Reflux(many types) and "asthma." then this just happened to be on the TV the other night/ http://www.kqed.org/quest/television/asthma

Not until reading these posts did I understand what she was talking about in regards to the Silent Reflux because I never had heartburn.

I just visited supposedly the best natureopath Dr. in the city last week. Waiting on blood results before we meet again to look at this not from the conventional route. The most intense 2 hour initial interview I have ever had. Until then I will start taking the 60 mg of Dexilant the allergist prescribed me. Does anybody have a recommendation for a GI Dr. in the bay Area, hopefully at Stanford since the docs at UCSF have unknowingly tried to kill me a few times already.

[echo]

bump. good info for those who haven't seen this thread yet.

BTW, I have been using the Betaine HCl now for several months, and WOW what a difference... reflux is gone. 1 pill per day with dinner, any more than that and the reflux comes back double. YMMV.