SLEEP AND NOCTURNAL ACID REFLUX IN NORMAL SUBJECTS AND PATIENTS WITH REFLUX ESOPHAGITIS

被引:121
作者
FREIDIN, N [1 ]
FISHER, MJ [1 ]
TAYLOR, W [1 ]
BOYD, D [1 ]
SURRATT, P [1 ]
MCCALLUM, RW [1 ]
MITTAL, RK [1 ]
机构
[1] UNIV VIRGINIA, HLTH SCI CTR, DEPT INTERNAL MED, BOX 145, CHARLOTTESVILLE, VA 22908 USA
关键词
D O I
10.1136/gut.32.11.1275
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Nocturnal gastro-oesophageal reflux may be important in the pathogenesis of reflux oesophagitis. This study aimed to determine whether: (1) gastro-oesophageal reflux occurs during sleep in patients with reflux oesophagitis and, if so, to explore the mechanism, and (2) the sleep pattern of patients with oesophagitis is different from that of control subjects. After a standard evening meal, simultaneous manometric, oesophageal pH, and polysomnographic recordings were obtained in 11 patients with endoscopic oesophagitis and 11 control subjects. Patients with gastro-oesophageal reflux disease had significantly more total reflux episodes throughout the nocturnal monitoring period than control subjects (105 upsilon 6). Ninety two of 105 episodes of gastro-oesophageal reflux in patients occurred during the awake state and 10 during sleep stage II. A number of reflux episodes occurred during brief periods of arousal from the various sleep stages. Of the 105 reflux events recorded in patients, 42 were induced by transient lower oesophageal sphincter relaxation, 20 by stress reflux, 22 by free reflux mechanisms, and in 21 the mechanism was unclear. The sleep pattern and the time spent in each sleep stage was not different between the two groups. It is concluded that the awake state is crucial for the occurrence of nocturnal reflux episodes in normal subjects as well as in patients with reflux oesophagitis and that the difference between the frequency of gastro-oesophageal reflux between normal subjects and patients cannot be explained by different sleep patterns.
引用
收藏
页码:1275 / 1279
页数:5
相关论文
共 21 条
[1]  
Agnew H W Jr, 1966, Psychophysiology, V2, P263, DOI 10.1111/j.1469-8986.1966.tb02650.x
[2]   ESOPHAGEAL MOTOR EVENTS AT THE OCCURRENCE OF ACID REFLUX AND DURING ENDOGENOUS ACID EXPOSURE IN HEALTHY-SUBJECTS AND IN PATIENTS WITH ESOPHAGITIS [J].
BALDI, F ;
FERRARINI, F ;
BALESTRA, R ;
BORIONI, D ;
LONGANESI, A ;
MIGLIOLI, M ;
BARBARA, L .
GUT, 1985, 26 (04) :336-341
[3]  
Christensen J, 1987, PHYSL GASTROINTESTIN, V1, P595
[4]  
COBLE P, 1974, BIOL PSYCHIAT, V9, P215
[5]   PATTERNS OF GASTROESOPHAGEAL REFLUX IN HEALTH AND DISEASE [J].
DEMEESTER, TR ;
JOHNSON, LF ;
JOSEPH, GJ ;
TOSCANO, MS ;
HALL, AW ;
SKINNER, DB .
ANNALS OF SURGERY, 1976, 184 (04) :459-470
[6]   MECHANISM OF GASTROESOPHAGEAL REFLUX IN RECUMBENT ASYMPTOMATIC HUMAN-SUBJECTS [J].
DENT, J ;
DODDS, WJ ;
FRIEDMAN, RH ;
SEKIGUCHI, T ;
HOGAN, WJ ;
ARNDORFER, RC ;
PETRIE, DJ .
JOURNAL OF CLINICAL INVESTIGATION, 1980, 65 (02) :256-267
[7]  
DODDS WJ, 1981, GASTROENTEROLOGY, V81, P376
[8]   MECHANISMS OF GASTRO-ESOPHAGEAL REFLUX IN PATIENTS WITH REFLUX ESOPHAGITIS [J].
DODDS, WJ ;
DENT, J ;
HOGAN, WJ ;
HELM, JF ;
HAUSER, R ;
PATEL, GK ;
EGIDE, MS .
NEW ENGLAND JOURNAL OF MEDICINE, 1982, 307 (25) :1547-1552
[9]   THE ROLE OF PROLONGED ESOPHAGEAL PH MONITORING IN THE DIAGNOSIS OF GASTROESOPHAGEAL REFLUX [J].
FINK, SM ;
MCCALLUM, RW .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1984, 252 (09) :1160-1164
[10]  
JOHNSON LF, 1974, AM J GASTROENTEROL, V62, P325