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Meta-Analysis of the Effect of Proton Pump Inhibitors on Obstructive Sleep Apnea Symptoms and Indices in Patients with Gastroesophageal Reflux Disease
Open accessAbstract
This study was designed to assess evidence for an association between the treatment of gastroesophageal reflux disease (GERD) with proton pump inhibitors (PPIs) and improvement in obstructive sleep apnea (OSA). We conducted a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies to evaluate the treatment effect of PPIs on OSA symptoms and indices in patients with GERD. EMBASE, MEDLINE, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov were reviewed up to October 2014. From 238 articles, two randomized trials and four prospective cohort studies were selected. In four cohort studies there were no differences in the apnea-hypopnea indices before and after treatment with PPIs (standard mean difference, 0.21; 95% confidence interval, -0.11 to 0.54). There was moderate heterogeneity among these studies. Two cohort studies revealed significantly decreased apnea indices after treatment (percent change, 31% and 35%), but one showed no significant difference. A significant improvement in the Epworth Sleepiness Scale was observed in three cohort studies and one trial. The frequency of apnea attacks recorded in diaries was decreased by 73% in one trial. In conclusion, available studies do not provide enough evidence to make firm conclusions about the effects of PPI treatment on OSA symptoms and indices in patients with concomitant GERD. Controlled clinical trials with larger sample sizes are needed to evaluate these associations. We recommend PPIs in OSA patients with concomitant GERD to treat reflux symptoms. This treatment may improve the quality of sleep without any effect on apnea-hypopnea indices.
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Treatment of gastroesophageal reflux disease significantly reduces snoring and patient-reported daytime sleepiness and improves sleep quality.
“Treatment of GERD has demonstrated significant reduction in snoring and patient-reported daytime sleepiness and improved sleep quality.927,940”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [940]
The Results report significantly improved patient-reported Epworth Sleepiness Scale scores and decreased snoring reported by bed partners after proton pump inhibitor treatment in patients with both GERD and obstructive sleep apnea; they do not establish that the snoring decrease was statistically significant. The paper says treatment may improve sleep quality, but its Results report no significant change in sleep-related quality of life in one trial. The claim presents these limited findings as established effects of GERD treatment more generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPatients with both obstructive sleep apnea and gastroesophageal reflux have a higher body mass index than patients with obstructive sleep apnea alone.
“While patients with OSA and gastroesophageal reflux have been shown to have a higher BMI than patients with OSA alone”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [940]
The introductory passage says obesity is a shared risk factor for OSA and GERD, but does not compare BMI between patients with both conditions and patients with OSA alone. Table 1 lists BMI for patients in PPI studies, without an OSA-only comparison group. Searches for higher BMI and body mass index found no passage establishing the claimed difference. (LLM, conf=0.76)
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Cited by
Sorted by citations
International Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350
Metadata
- Authors
- Rassameehiran, S., Klomjit, S., Hosiriluck, N., & Nugent, K.
- Affiliations
- Texas Tech University (US)
- Corresponding author
- Rassameehiran, Supannee
- ORCID
- Nugent, Kenneth
- Venue
- Baylor University Medical Center Proceedings
- Publisher
- Informa UK Limited
- Published
- 2016-01
- Volume
- 29
- Issue
- 1
- Pages
- 3-6
- ISSN
- 0899-8280 (ISSN-L)
- 1525-3252
- PMC
- PMC4677839
- OpenAlex
- W2412000252
- Cited by
- 17
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 3 · 2018: 3 · 2017: 2 · 2016: 2
- FWCI
- 0.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Baylor University Medical Center Proceedings (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- proton pump inhibitors, gastroesophageal reflux disease, obstructive sleep apnea, apnea-hypopnea index, Epworth Sleepiness Scale, sleep quality
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