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Editorials |

Sleep-Related Breathing Disorders : Is It All About Apnea?

William C. Orr, PhD
Author and Funding Information

Affiliations: Oklahoma City, OK 
 ,  Dr. Orr is President and Chief Executive Officer of the Lynn Health Science Institute.

Correspondence to: William C. Orr, PhD, Lynn Health Science Institute, Suite 130, 5300 N. Independence, Oklahoma City, OK 73112



Chest. 2002;121(1):8-11. doi:10.1378/chest.121.1.8
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Extract

It is generally accepted that sleep represents a period of abnormal or unstable respiration, largely manifest as either obstructive or central apnea. Recognition of the clinical significance and ubiquity of these phenomena has driven the widespread proliferation of sleep laboratories largely dedicated to studying sleep apnea. The clinical presentation of obstructive sleep apnea (OSA) is well-known to clinicians and includes obesity, snoring, and daytime hypersomnolence. The article in this issue of CHEST (see page 158) by Gislason and colleagues has drawn our attention to another sleep-related phenomenon that may also be exacerbating and/or contributing to sleep-related breathing disorders, ie, gastroesophageal reflux (GER). They have shown a strong relationship between respiratory symptoms and sleep-related heartburn, and they have shown in other publications12 the relationship of sleep-related heartburn to symptoms of OSA such as snoring and obesity. It would appear from this research, and other outcomes that have been published from the European Community Respiratory Health Survey, that sleep-related GER may be another one of those “things that go bump in the night.” In the current article, the authors establish a strong coincidence of asthmatic and other respiratory symptoms occurring in individuals who report symptoms of GER (ie, heartburn and belching) occurring at least 1 to 2 nights per week. A strong correlation, however, or even a robust odds ratio does not establish a causal relationship. Are there data available that would suggest that these events may have an underlying common cause or linkage?


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