Tıkayıcı uyku apnesi sendromu ve larengofarengeal reflü
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Date
2009
Authors
Eryılmaz, Aylin
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalısmanın amacı, Tıkayıcı Uyku Apnesi Sendromu (TUAS) ve Larengofarengeal reflü (LFR)'nün birlikteliginin sıklıgını saptamak, LFR tedavisinin TUAS, sürekli pozitif havayolu basıncı (Continuous Positive Airway Pressure; CPAP) tedavisinin ise LFR üzerindeki etkisini arastırmaktır. 2007–Mart 2009 tarihleri arasında ilk asamada; TUAS öntanısıyla, 44 hastaya eszamanlı polisomnografi (PSG) ve çift problu 24 saat pH metre yapıldı. kinci asamada ise; bu testlerde TUAS ve LFR beraber saptanan ve tedavi protokolu tam uygulanabilen 20 hasta alındı. Bu 20 hastadan; hafif veya orta derecede TUAS saptanan 10 hastaya 3 ay süresince LFR tedavisi verildi. Agır TUAS'lı 10 hastaya ise 3 ay süresince CPAP uygulandı. Bu 3 aylık tedavilerin sonrasında es zamanlı çift problu 24 saat pHmetre ve PSG tetkikleri tekrarlandı. Hastaların; Epworth uykululuk skalası (EUS), Reflü Semptom ndeksi (RS ), Reflü Bulgu ndeksi (RB ), horlama görsel analog skalası (GAS) da degerlendirildi. LFR tedavisinin LFR ve TUAS üzerindeki etkinligi ve CPAP tedavisini LFR ve TUAS üzerindeki etkinligi hem objektif hem de subjektif olarak arastırıldı. Çalısmaya ilk asamada alınan 44 hastanın 25'inde (%57) TUAS ve LFR birlikteligi saptandı. LFR tedavisi verilen grupta LFR tedavisinin TUAS'da polisomnografi verilerinde düzelme saglamadıgı, ancak EUS ve horlama VAS'da istatistiksel olarak anlamlı bir düzelme sagladıgı görülmüstür (p<0,05). CPAP tedavisi verilen grupta CPAP tedavisinin 24 saatlik pH metre bulguları üzerindeki etkisi anlamlı saptanmamıstır. Ancak CPAP tedavisi RS ve RB üzerinde istatistiksel olarak anlamlı bir düzelme saglamıstır (p<0,05). TUAS hastalarında LFR ve LFR hastalarında TUAS sıklıgı nedeniyle sorgulamada titizlikle yaklasılmalıdır. TUAS ve LFR'si olan hastalarda her iki hastalık da dikkate alınarak hastaların tedavisi düzenlenmelidir.
The aim of this study is to evaluate the frequency of the association of Obstructive Sleep Apnea Syndrome (OSAS) and laryngopharengeal reflux (LFR), and to determine the effects of LFR therapy on OSAS, and CPAP therapy on LFR. At the first stage of the study, between 2007 and March 2009, 44 patients with OSAS symptoms underwent double probe 24 hour pH monitoring simultaneously with polysomnography. At the second stage, 20 patients who were observed to have OSAS and LFR coexistence and had appropriate health conditions to take the treatment protocol were enrolled. Of these 20 patients, 10, who had mild to moderate OSAS were given LFR treatment for three months. The other 10 had severe OSAS and were given CPAP treatment for three months. After this treatment period of three months, double probe 24 four hour pH monitoring simultaneously with polysomnography was repeated. Also, all the patients were evaluated through Epworth Sleepiness Scale (ESS), Reflux Symptom Index (RSI), Reflux Finding Index (RFI) and snoring visual analogue scale (VAS). Thus, the efficiency of LFR and CPAP treatments on LFR and OSAS were studied both objectively and subjectively. Of the 44 patients at the first stage, 25 (57%) were found to have OSAS and LFR coexistence. LFR treatment didn't reduce the polisomnography parameters in OSAS in the LFR group, but it statistically significantly reduced ESS and snoring VAS parameters (p<0,05). In CPAP group, the effects of the CPAP treatment on 24 hour pH monitoring parameters weren't found to be significant, yet it statistically significantly reduced RSI and RFI (p<0,05). Due to the high frequency of LFR among OSAS patients and high frequency of OSAS among LFR patients, these patients should be inspected carefully. In patients with OSAS and LFR coexistence, the treatment must be regulated with a consideration of both diseases.
The aim of this study is to evaluate the frequency of the association of Obstructive Sleep Apnea Syndrome (OSAS) and laryngopharengeal reflux (LFR), and to determine the effects of LFR therapy on OSAS, and CPAP therapy on LFR. At the first stage of the study, between 2007 and March 2009, 44 patients with OSAS symptoms underwent double probe 24 hour pH monitoring simultaneously with polysomnography. At the second stage, 20 patients who were observed to have OSAS and LFR coexistence and had appropriate health conditions to take the treatment protocol were enrolled. Of these 20 patients, 10, who had mild to moderate OSAS were given LFR treatment for three months. The other 10 had severe OSAS and were given CPAP treatment for three months. After this treatment period of three months, double probe 24 four hour pH monitoring simultaneously with polysomnography was repeated. Also, all the patients were evaluated through Epworth Sleepiness Scale (ESS), Reflux Symptom Index (RSI), Reflux Finding Index (RFI) and snoring visual analogue scale (VAS). Thus, the efficiency of LFR and CPAP treatments on LFR and OSAS were studied both objectively and subjectively. Of the 44 patients at the first stage, 25 (57%) were found to have OSAS and LFR coexistence. LFR treatment didn't reduce the polisomnography parameters in OSAS in the LFR group, but it statistically significantly reduced ESS and snoring VAS parameters (p<0,05). In CPAP group, the effects of the CPAP treatment on 24 hour pH monitoring parameters weren't found to be significant, yet it statistically significantly reduced RSI and RFI (p<0,05). Due to the high frequency of LFR among OSAS patients and high frequency of OSAS among LFR patients, these patients should be inspected carefully. In patients with OSAS and LFR coexistence, the treatment must be regulated with a consideration of both diseases.
Description
Keywords
Tıkayıcı uyku apnesi sendromu, Larengofarengeal reflü, Sürekli pozitif basınçlı hava üfleyen cihaz, Polisomnografi, Çift problu 24 saatlik pH metre, Obstructive sleep apnea syndrome, Laryngopharengeal reflux, Continues positive airway pressure therapy, Polysomnography, Double probe 24 hour pH monitoring
Citation
Eryılmaz, A. (2009). Tıkayıcı uyku apnesi sendromu ve larengofarengeal reflü. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.