[Association between obstructive sleep apnea-hypopnea syndrome and reflux esophagitis: a cross-sectional study].

Abstract

Objective: This study aimed to evaluate the association between obstructive sleep apnea-hypopnea syndrome (OSAHS) and reflux esophagitis (RE). Methods: This cross-sectional study retrospectively analyzed 218 patients diagnosed with OSAHS by polysomnography (PSG) and who also had undergone gastroscopy at the First People's Hospital of Yunnan Province from January 2021 to December 2021. The cohort comprised 91 males and 127 females, aged from 19 to 78 years (40.7±13.2). Clinical data, PSG parameters, and gastroscopy findings were collected. The prevalence of RE among OSAHS patients was calculated, potential risk factors for RE were evaluated. Differences in PSG parameters between patients with and without RE were analyzed. Statistical analyses were conducted using SPSS 26.0. Results: The prevalence of RE in OSAHS patients was 20.6% (45/218). Males had a significantly higher RE prevalence than females (31.9% vs. 12.6%, χ²=12.02, P<0.05). The difference remained significant after adjusting for confounding factors (34.9% vs. 11.1%, χ²=10.08, P<0.05). No significant variation in RE prevalence was observed across age groups. However, after adjusting for confounding factors, a significant difference was found between overweight and obese BMI groups (12.5% vs. 29.2%, χ²=4.04, P<0.05). When stratified by apnea-hypopnea index (AHI) severity, RE prevalence increased progressively in mild (7.1%), moderate (18.8%), and severe (30.1%) groups, with statistically significant differences (χ²=11.45, P<0.05). Positive correlations were found between RE and male sex, AHI, longest apnea time (LAT), and time spent with oxygen saturation below 90% (TS90%) (rs=0.24, 0.18, 0.17, 0.14, respectively, P<0.05). Regression analysis showed that identified male sex was the primary independent predictor of RE. Patients with RE exhibited higher AHI, TS90%, and LAT compared to those without RE (P<0.05). Conclusion: This single-center hospital-based study revealed a relatively high prevalence of reflux esophagitis (20.6%) among patients with OSAHS. Male sex was identified as the main independent factor associated with RE. Furthermore, RE prevalence increased with greater AHI, BMI, LAT and TS90%.