Acid Reflux and Sleep Apnea Go Hand In Hand

If your patient has acid reflux, theres a good chance they have sleep apnea and vice versa. Research shows that a relationship exists between the two diseases. One report suggests that around 60 percent of patients with OSA also experience GERD (sleepapnea.org).

Understanding Why The Diseases Are Linked

When a patient stops breathing during an episode of sleep apnea, the air pressure in the lungs will change. This can cause acid reflux, drawing stomach acid back up into the esophagus. Another factor that can cause acid reflux is that they normally breathe harder right after  breathing has restarted. This more forceful breath could also draw stomach acid back up into the esophagus. 

Acid reflux can also cause sleep apnea. When your patient has acid reflux during the night, they may have spasms of the throat muscles and vocal cords that can block the airway and lead to obstructive sleep apnea.

Doctors Often Recommend Elevating The Head During Sleep For Both Conditions

Acid reflux is worse at night due to gravity. When the patient is active and awake, they're normally in an upright position – gravity helps digestion and keeps acid from coming back up into the esophagus. At night, as they relax or lay down in bed, it’s easier for acid to make its way back up into the esophagus.  Sleeping on a wedge can help reduce acid reflux symptoms.

Doctors often recommend sleeping with the torso elevated to improve breathing and to help sleep apnea symptoms. The Sleep Apnea Association says to use wedges, not soft pillows, because they help achieve the right position that keeps the airway more open. 

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CPAP Therapy Obviously Helps OSA, But Also Improves GERD Too!

Early studies indicate that CPAP therapy may help improve the symptoms of nocturnal GERD in patients with obstructive sleep apnea. A study published in the Journal of Clinical Sleep Medicine showed that 62 of 79 patients (78%) with sleep apnea also had symptoms of acid reflux. Their heartburn score decreased  62 percent when they were adherent to CPAP therapy. The study also found a progressive reduction in their heartburn score with increased CPAP adherence. A minimum CPAP usage of at least 4 hours per night for 25 percent of nights or more was needed to achieve any acid reflux benefit. 

A CPAP pillow can help improve CPAP comfort and increase compliance. A study of CPAP users showed that 97%  experienced improved comfort with their CPAP therapy and 94% slept better through the night when they used a CPAPMax Pillow.