Abstract
To determine whether gastroesophageal reflux (GER) might be a factor in the pathogenesis of (awake) apnea in some infants, we analysed the frequency of prolonged apnea (> 15s) and of irregulary frequently repeated short apneas (5-15s) (“respiratory dysfunction) in control infants (n:584), infants with a GER-pathology (n:60), and in infants presenting with an ALTE (Acute Life-Threatening Event) (n:62). In infants with a resp dysf (n:76), the incidence of GER (assessed by pH monitoring) was looked after. Resp function during sleep was assessed by Oxy-Cardio-Respirography (n:197) or by polysomnography (n:585). Results failed to show any causal relationship between prolonged apnea and GER. Resp dysf, although NOT indicating an increased SIDS-risk, appeared to be related to GER (p<0.01). pH Data were abnormal in 8%, and resp dysf present in 5% of the control infants. In controls with a resp dysf, GER was present in 76%. According to different parts of the study GER-path was detected in 43-100%; a resp dysf was observed in 50-100%. Resp dysf was associated with abnormal pH data in 40-71%. If the GER was treated efficiently (significant decrease or normalisation of pH data), resp dysf disappeared in 95%. If GER was resistant to therapy, resp dysf was still present in 79% (15/19 infants) (p< 0.001). If resp dysf persisted, GER was still present in 76% (16/21 infants) (p<0.01). Analysis of pH data and sleep investigations were performed double blind. A majority of ALTE-infants have significant GER, especially if ALTE occured awake. We conclude that GER in infants is often associated to a typical breathing pattern during sleep.
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Vandenplas, Y., Sacre, L. 74 RESPIRATORY ABNORMALITIES DURING SLEEP ASSOCIATED WITH GASTROESOPHAGEAL REFLUX IN INFANCY. Pediatr Res 24, 417 (1988). https://doi.org/10.1203/00006450-198809000-00097
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DOI: https://doi.org/10.1203/00006450-198809000-00097