GERD and Sleep Apnea often seem to be comorbidities of each other. I know lots has been posted about GERD in the past but since I didn't know I had it I never paid any attention to it.

I've been thinking about GERD and wondering what the relationship is to SDB. I have wondered about a number of possibilities:

1. The sleep apnea causes the GERD. Could the repeated apneas somehow cause the sphincter to stop working correctly?

2. The CPAP treatment causes the GERD. Since CPAP splints open the airway it would seem possible that it could also splint open the esophagus allowing stomach acid to come up and injure the throat? I personally wonder if this is what happened to me. I had no problem with GERD until I started using the Oracle mask. Maybe the drying effect of the Oracle mask on the throat could also be a factor?

3. Maybe GERD and Apnea have an underlying root cause? They both seem to be failures of muscle systems in the airway.

jskinner wrote:........
1. The sleep apnea causes the GERD. Could the repeated apneas could somehow cause sphincter to stop working correctly?

..........

That was my vote. There is little doubt that in all the years of struggling to breathe at night violent muscle contractions forced acid into my esophagus. After I started cpap the doc looked with an endoscope and saw damage to the sphincters. Three months of Prevacid and elevation of the head of my bed and I no longer have GERD.

I would not rule out that cases of 2 & 3 exist in some people.

Like rooster, I suspect it differs from person to person. I was surprised to see such a reduction in my GERD symptoms when I started the CPAP. No one even suggested sleep apnea when I was diagnosed with GERD, though, nor did anyone mention my GERD might get better when I started CPAP therapy.

I suffered with GERD for several years. In 2002 I had the Nissen surgery to repair the sphincter...this completely cured the GERD. I was diagnosed with OSA this past fall.

I was diagnosed with GERD, without having any symptoms, after an EGD. My GI doctor found that I had severe erosive esophagitis and that it was almost at stage 4. I was shocked as I had never had any heartburn. I was diagnosed about a year later with the sleep apnea. In retrospect, I may have been having symptoms of both the GERD and the apnea for some time but my doctors did not recognize them for what they were. I kept telling them that I wasn't sleeping, that I was very fatigued, that I was having constant coughing spells at night, that I was waking up sputtering and choking in my sleep, etc. I was asked if I was having heartburn and I said no. I was asked if I snored and I said no so the pulmonary specialist, that I had been referred to, immediately crossed both GERD and OSA off her list without further testing. Big mistake. I did tell the doctor that it had been noted that my O2 saturations had been low at night during my last couple of hospitalizations and no one seemed to be too bothered by it. She didn't seem to care much either.

My big problem has been the last couple of weeks. I am suddenly having tons of heartburn at night while using my CPAP. I almost started a new post to see if others might be having this issue but I did a search and I saw that most people indicated that their GERD improved once they started CPAP. Maybe my erosive esophagitis is improved, I am not sure but this new heartburn is terrible. I wake up drowning is stomach acid. I had to pull my CPAP off the other night and I couldn't put it back on all night. I never take my CPAP off at night. Even when I am having a hard time sleeping with the CPAP, I still keep my mask on.

My AHI goes way up on the nights that I am having heartburn too. I have not changed my eating habits, my Prilosec dosing, or sleep hygiene so I am really perplexed. I do not even know which doctor to call about the problem. My ENT who diagnosed the OSA or my GI doctor or my PCP???? I am definitely having aerophagia too and maybe this is a big contributing factor or even the cause. Anyone have any ideas or pearls of wisdom? I would love to get this under control.

In my case GERD was diagnosed years before the OSA diagnosis but I didn't start taking regular
GERD meds until just after going on cpap.

Approx Timeline:

1989 did a sleep study - given the all clear (no OSA)
1997 acid stomach beginning to be a big problem - started using Gaviscon liquid
1998 went into clinic for an eval - was told stomach valve was weak - watch foods & take meds
2005 did another sleep study - diagnosed with OSA & 40 AHI
2005 put on pariet GERD meds by doc
2006 another sleep study (after losing a lot of weight) still diagnosed with OSA
2008 discussed with doc taking GERD meds 2 x per day - he agreed - have been doing so but not sure extra does is needed

DSM

I think the air that is pumped into you through CPAP aggravates any latent stomach issues and intensifies them. ....taking what may have been a minor issue in the stomach and turning it into a major issue in the throat.

LSAT wrote:I suffered with GERD for several years. In 2002 I had the Nissen surgery to repair the sphincter...this completely cured the GERD. I was diagnosed with OSA this past fall.

What was the recovery like?

Thanks,

I'm pretty sure I had OSA most of my life. I believe that the GERD came later, but who knows. I don't have dramatic symptoms with the GERD and hardly every snore. The reason that my GERD was dx'd first was that my doctor refused to believe I had OSA. GERD was a more mainstream diagnosis. I had to embellish my symptoms to get even the GERD diagnosis, though. When I told him I was having a lot of burning and acid coming up, he agreed to the tests (stage 3 esophagitis it turned out). I didn't have acid coming up, but rather had silent gerd and had figured this out from some research online. But the docs need to write something down to justify the testing. I gave him what he needed. Because I was a woman and thin, he just didn't believe OSA could be the cause of the fatigue, etc. He talked me out of it, and I believed him. Suffered OSA 5 extra years. Luckily I no longer have managed care and the doctors are not so stingy with the diagnostic testing.

Rooster...My recovery was textbook......a couple weeks of soft foods and then pretty much back to normal foods. Today I eat everything. I have not taken a med since the day of surgery. The key is to be tested to be sure you are a good candidate for the proceedure and to find a surgeon that is very experienced with this surgery. It is done laporoscopically...in one day and out the next.

So... looking at those poll results, I'm thinking there's a potential lesson hiding in that data: if you have an apnea diagnosis but not a GERD diagnosis, you just might want your doctor to look a little harder.

Silent GERD is a definite possibility---but a hard type of GERD to properly diagnose. I only had my "silent GERD" diagnosed after an unexpected trip to the ER. Food was literally stuck in my acid-deteriorated and swollen esophagus. I probably had apnea at the time. But the apnea diagnosis didn't come until a few years later.

Silent Acid Reflux Google Search
Silent GERD Google Search

What tests should be performed to access the extent of GERD damage. My ENT did an endoscopy when I complained of feeling like I had a lump in my throat. He discovered a sore spot on my Epiglottis, said the cause was GERD, and sent me home with some Nexium samples.

Hi James,

I have osa but have not been diagnosed with gerd! And am praying I never will...

SleepNMore

Saw my GI doc last week but he did not think I needed an endo. After I got home I thought about it and even though I had an endo about 15 yrs. ago I decided that it was worth doing again. I called his office this week and insisted on doing the endo-they are supposed to call me back today with an appt. date. The doc acted like I was over reacting but I DO NOT think this is something that should be ignored. I know I have a hiatal hernia but the CPAP therapy has really kicked it up a notch and I find it a daily source of irritation. The PPIs give me a horrible headache so I've been using OTC Pepcid for a few months now. I think it's time for an endo, I hope the doc doesn't blow me off. IF that is the case it' s off to another doctor!!

jskinner wrote:What tests should be performed to access the extent of GERD damage. My ENT did an endoscopy when I complained of feeling like I had a lump in my throat. He discovered a sore spot on my Epiglottis, said the cause was GERD, and sent me home with some Nexium samples.

Esophagogastroduodenoscopy (EGD) by a good GI doctor.