Association between non-erosive reflux disease and high risk of obstructive sleep apnea in Korean population

Background/Aims: Obstructive sleep apnea is becoming more important in gastroesophageal reflux disease (GERD) patients. This study investigatedthe prevalence of high risk for obstructive sleep apnea in GERD patients in comparison with that in healthy controls using the Berlin Questionnaire. We also investigated the risk factors for obstructive sleep apnea in GERD patients. Methods: We enrolled 1,007 subjects: 776 healthy controls, 115 individuals with erosive reflux disease, and 116 with non-erosive refluxdisease. GERD was diagnosed and classified using endoscopy and a reflux questionnaire. The Berlin Questionnaire was used toevaluate obstructive sleep apnea. Results: More patients in the GERD group (28.2%) had higher risk for obstructive sleep apnea than healthy controls (20.4%, P =0.036). More patients with non-erosive disease (32.8%) had higher risk for obstructive sleep apnea (OSA) than patients witherosive disease (20.9%) and controls (20.4%, P = 0.010). On multivariate analysis, non-erosive disease was a high risk factorfor obstructive sleep apnea (odds ratio [OR], 1.82; P = 0.011). Age = 55 years (OR, 1.83; P < 0.001) and a high body massindex (= 25 kg/m²) (OR, 2.76; P < 0.001) were also identified as risk factors. Nocturnal GERD was related to high risk forOSA in non-erosive disease patients (OR, 2.97; P = 0.019), but not in erosive disease patients. Conclusions: High risk for OSA is more prevalent in GERD patients than in controls. Non-erosive reflux disease, age = 55, and a high BMIare associated with high risk for OSA.