The Correlation Analyze Of Obstructive Sleep Apnea Syndrome And Esophageal Motility Disorders

Background:Obstructive sleep apnea syndrome(OSAS)clinically featured by snoring,stop breathing during sleep and day time sleepness has drew more and more clinical attention in recent years.The main reason of OSAS is the repeated collapse of upper airway during sleep,which cause intermittent hypoxia,carbon dioxide retention,and intrathoracic negative pressure.This disorser can cause the chronic damage of multiple organs,which lead to the occurrence of many important organs and organic changes.It has been noticed that patients with OSAS had higher incidence of gastric esophageal recurrent disease(GERD);however,the relationship between OSAS and GERD has not been well studied.High resolution manometry is a technique which detect the pressure of different parts of esophagus and esophagus momentum indicator,which can be helpful to understand the esophagus kinetic characteristics of patients with GERD,and to explore the relationship between OSAS and esophageal motility disorders.Objective:To measure the pressure changing characteristics of upper esophageal sphincter(UES),lower esophageal sphincter(LES)and the esophagus kinetic characteristics of patients with OSAS.Methods:High resolution manometry was performed on fourty seven patients with OSAHS diagnosed by polysomnography(PSG)(including 14 mild cases,16 moderate cases and 17 severe cases)and 11 normal volunteers.Changes of LES related index(lower esophageal sphincter length,lower esophageal sphincter pressure,residual pressure of lower esophageal sphincter),UES related index(upper esophageal sphincter pressure,residual pressure of upper esophageal sphincter,relaxation duration and recovery time)and esophageal dynamic correlation index(esophageal distal contraction integral and esophageal contraction frontier speed)were recorded for further analysis.Result:The patientsin severe OSAS group were significantly older other groups.(P<0.05),respectively.Incidence of pharyngeal paraesthesia in OSAS group was greater than the control group,whereas the incidence in medium OSAS group was significantly greater than that in mild and severe OSAS groups.Average LES resting pressure and residual pressure in OSAS patients were significantly lower than those in the control group(P<0.05).Differences in those items related to UES between OSAS and control groups were not statistically significant(P>0.05),whreras the differences inmean wave durationanddouble-peaked wave betweensevere OSAS groupandothergroups were significant.(P<0.05).Up3.0cm wave amplitude in mildandmedium OSAS patients were significantly lower than those in the control group(P<0.05),and the DCI in severe OSAS group were significantlygreater than those in mildandmedium OSAS group(P<0.05).Conclusions:OSAS patients,especially inseveregroup,might have more incidence in LESlow pressure,UES relaxation durationand recovery timeextend,and esophageal motility disorders.which induced moreclinical symptomssuchas acid reflux,pharyngeal paraesthesiaand dysphagia.These symptoms may owing to the dysfunction of LES & UES anti-flow barrier,that the removal ability of the reflux is reduced,and esophageal motility decreased.