Understanding Upper Esophageal Sphincter Apnea

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The Link Between Acid Reflux and Sleep Apnea

written by: CatNorth • edited by: lrohner • updated: 5/31/2011

Learn about the causes and treatment options for obstructive sleep apnea and the possible correlation between sleep apnea and acid reflux complications. Become familiar with associated symptoms and how sleep apnea can affect your health.

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    Sleep apnea occurs when a person's breathing continuously stops and starts again during sleep time. Any type of sleep apnea can be serious, and it can become life-threatening without proper diagnosis and treatment. If you snore excessively and feel fatigued during the day, you could have a form of sleep apnea, according to MayoClinic.com.

    The two main types of sleep apnea are obstructive sleep apnea, which is typically caused by slack throat muscles, and central sleep apnea, which is due to brain signal malfunction. Many medical professionals, however, believe there is also an association between acid reflux and sleep apnea. This type of obstructive sleep apnea is often referred to as upper esophageal sphincter apnea.

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    Terminology

    The gastroesophageal sphincter makes up the last few centimeters of the esophagus, and it functions to prevent gastric reflux from entering the esophagus. Obstructive sleep apnea can be perpetuated when acid reflux causes inflammation in the throat, which then can set off a series of reactions that lead to more breathing obstruction. Further, initial sleep apnea can trigger acid reflux.

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    Causes

    A combination of natural physiological changes can lead to sleep apnea in relation to the esophageal sphincter. When you fall asleep, several things automatically happen in your body:

    • Gastric acid secretion is increased
    • Stomach emptying is interrupted
    • Esophageal clearance is interrupted
    • Upper esophageal pressure is decreased.

    Because of these physiological changes, nighttime acid reflux is more challenging to treat with common medications. If you already have typical breathing obstruction apnea, slack throat muscles can help to create a vacuum effect in the throat, according to Park. This can then cause a suction effect leading to stomach juices being pulled up from the stomach, which along with natural physiological changes only compounds any existing issues with acid reflux.

    Stomach acid in the throat exacerbates obstructive sleep apnea. Your throat and tonsils, if you still have them, can become swollen. This only adds to breathing obstruction that causes sleep apnea.

    Further, the stomach acid desensitizes “protective chemo-receptors" that help to arouse you from sleep so that you can swallow to get rid of some of the acid and avoid breathing it into your lungs, adds Park.

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    Diagnosis

    If you believe you have sleep apnea, it is important to get a proper diagnosis from your health care provider. Avoid trying to diagnose and treat your sleep apnea yourself. You may not understand the true cause of your sleep disorder and without the guidance of a health care professional, you might worsen the problem. If you have acid reflux issues, let your physician know your concerns about the possible connection to sleep apnea.

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    Treatment

    In some cases, sleep apnea requires surgery. Many of the procedures can be performed in a physician’s office, however, and a patient is not usually required to stay overnight in a hospital.

    Certain therapies can also help sleep apnea problems, such as continuous positive airway pressure (CPAP), adjustable airway pressure and oral appliances, according to MayoClinic.com. The first two therapies require a patient to wear a mask while sleeping so that applied air pressure can assist your breathing. The third therapy involves wearing an oral apparatus designed to help keep your throat open for better breathing while you sleep.

    With milder cases of sleep apnea, doctor-recommended lifestyle changes, such as weight loss or smoking cessation, may help remedy symptoms.

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    New Research

    Recent research indicates that there is no link between gastroesophageal reflux and obstructive sleep apnea, according to ScienceDaily. If you’re in doubt about your own sleep apnea diagnosis, reach out to other medical professionals for a second opinion. In light of continuous new research, the field of medicine often changes, as well as typical treatments and procedures. Further, sleep apnea remedies that work for one individual, might not work for another. It is important to advocate your own health care.

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    References

    Dr. Park -- Breath Better, Sleep Better, Live Better; How Reflux Aggravates Sleep Apnea; Steven Y. Park, M.D.; Apr. 19, 2011

    http://doctorstevenpark.com/tag/upper-esophageal-sphincter

    MayoClinic.com: Sleep Apnea

    http://www.mayoclinic.com/health/sleep-apnea/DS00148

    ScienceDaily: Link Between Acid Reflux and Sleep Apnea Challenged; Apr. 13, 2010

    http://www.sciencedaily.com/releases/2010/04/100406160711.htm

    Chest; Upper Esophageal Sphincter and Gastroesophageal Junction Pressure Changes Act to Prevent Gastroesophageal and Esophagopharyngeal Reflux During Apneic Episodes in Patients With Obstructive Sleep Apnea; Hiko Kuribayashi, MD, Benson T. Massey, MD, Muhammad Hafeezullah, MBBS, Lilani Perera, MD, Syed Q. Hussaini, MD, Linda Tatro, Ronald J. Darling, MD, Rose Franco, MD, FCCP, Reza Shaker, MD; April 2010

    http://chestjournal.chestpubs.org/content/137/4/769.short

    The Free Dictionary: gastroesophageal sphincter

    http://medical-dictionary.thefreedictionary.com/sphincter

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