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Obstructive sleep apnoea (OSA) and gastrooesophageal reflux may share more than a nighttime association.
Treating gastrooesophageal reflux with prolonged omeprazole (20 mg) therapy progressively reduces the frequency of obstructive sleep apnoea attacks.
Obstructive sleep apnoea (OSA) and gastrooesophageal reflux may share more than a nighttime association. While OSA can promote reflux through the marked negative intrathoracic pressure generated during apnoeic episodes, reflux may also act in the opposite direction by triggering or aggravating airway obstruction. This study explored whether controlling gastrooesophageal reflux with omeprazole (proton pump inhibitor, PPI) could influence the frequency of OSA attacks.
The study included 20 participants (mean age, 55.4 years; 17 males) with both conditions confirmed objectively. OSA was established via overnight polysomnography, while pathological gastrooesophageal reflux was confirmed via ambulatory 24-hour oesophageal pH monitoring. Participants first documented their apnoea attacks in a diary for 4 weeks without treatment.
They were then randomly allocated, under double-blind conditions, to receive omeprazole 20 mg (n=10) or placebo (n=10) for 6 weeks. Treatment consisted of one capsule 30 minutes prior to breakfast and one 30 minutes before dinner. Weekly and overall treatment-period frequencies of apnoea attacks were compared both between groups and against baseline values.
The mean weekly frequency of apnoea attacks in the omeprazole group dropped significantly during the overall treatment period compared with the baseline period and was lower than that observed in the placebo group. A significant between-group and within-group difference became evident from the third week of treatment. The reduction continued progressively throughout therapy, reaching approximately 73% by the sixth week in patients receiving omeprazole.
The progressive decline in apnoea attacks during omeprazole treatment suggests that gastrooesophageal reflux may be more than a consequence of OSA—it may also contribute to its initiation or worsening. Although the study was small, its findings highlight a potential bidirectional reflux–apnoea relationship and suggest that effective reflux control may impact sleep-apnoea severity.
Digestive and Liver Disease
Obstructive sleep apnoea is improved by a prolonged treatment of gastrooesophageal reflux with omeprazole
M Bortolotti et al.
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