Obstructive sleep apnea and GERD: Prevalence, sleep impact, and clinical association

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Created On: 14/11/2025

This study aimed to offer a comprehensive assessment of the association between obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD), specifically examining the prevalence of GERD among OSA patients and the potential influence of GERD on sleep parameters, including sleep architecture and apnea severity.

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Key take away

Patients with GERD experience reduced sleep efficiency and oxygen saturation. While a modest association with OSA exists, the impact on apnea severity and sleep stages is inconclusive.

Background

Method

A systematic search of PubMed, Embase, Cochrane Library, and Scopus was executed to identify studies exploring the connection between OSA and GERD in adult populations. Eligible studies investigated either the prevalence of GERD in OSA patients or the effect of GERD on sleep-related outcomes, including sleep stages, apnea severity, and Epworth Sleepiness Scale (ESS) scores.

Result

In this systematic review and meta-analysis, 49 studies fulfilled the inclusion criteria. The pooled analysis suggested a modest connection between OSA and an elevated risk of GERD, with a relative risk of 1.23, though this did not achieve statistical significance. Severe OSA patients illustrated a tendency toward more pronounced reflux symptoms when compared to those with mild OSA. Additionally, GERD sufferers showed markedly lower sleep efficiency and decreased oxygen saturation. Heterogeneity among studies was moderate, largely attributable to variations in patient characteristics and OSA severity.

Conclusion

A modest association was noted between GERD and OSA, with GERD patients exhibiting significantly lower sleep efficiency and reduced oxygen saturation. While severe OSA may be linked to increased reflux symptoms, no definitive relationship was observed between GERD and OSA severity or alterations in most sleep stages, highlighting the need for further investigation.