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More Than Just GERD: Obstructive Sleep Apnea Is Associated with IBS and Constipation
Conference paper

More Than Just GERD: Obstructive Sleep Apnea Is Associated with IBS and Constipation

Wendy A. Mikulski, David Anjelly, Radha V. Menon, James C. Reynolds, Joanne Getsy, Irvin Tantuco, Michel Alkhalil and Asyia S. Ahmad
Gastroenterology (New York, N.Y. 1943), v 134(4), pp A-425-A-425
2008
DOI: https://doi.org/10.1016/S0016-5085(08)61986-1

Abstract

INTRODUCTION: Obstructive sleep apnea (OSA) is associated with an increase in the activity of the sympathetic nervous system during both sleep and waking hours. Patients with OSA have an increased incidence of multi-system clinical consequences, such as HTN, seizures, and CVA, as a direct result of the over-activation of the sympathetic nervous system. In addition, there is a direct relationship between the severity of systemic sequelae and the severity of OSA (based on the Apnea-Hypopnea-Index (AHI)). Based on this premise, patients with OSA may exhibit symptoms of gastrointestinal dysmotility. To date, there have been no studies examining the possible relationship between OSA and GI symptoms other than GERD. Our study aims to determine the prevalence of GI symptoms in patients with documented but untreated OSA. METHODS: We prospectively administered the Rome III Diagnostic Questionnaire for the Adult Functional GI Disorders (containing 80 questions) to patients between the ages of 18-85 who presented for a sleep study at the Drexel University Sleep Center. Patients were excluded from the study if they refused to participate, had a negative sleep study, or if they were presently on treatment for OSA. RESULTS: Thirty-six patients were asked to participate, and 34 patients (94%) agreed and consented. Thirty of the 34 patients (88%) had studies that were positive for OSA. Of the positive studies 16/ 30 (53.3%) were classified as mild, 8/30 (26.7%) moderate, and 6/30 (20%) severe sleep apnea by the AHI. Twenty-six of 30 patients (86.7%) met symptomatic or diagnostic criteria based on the Rome III questionnaire, with 11/30 (42.3%) patients exhibiting two or more diagnoses. As previously reported, the most common upper GI symptom was heartburn in 5/30 (16.7%). Other upper GI symptoms elicited were aerophagia in 4/30 (13.3%), and bloating in 3/30 (10%). The most common GI diagnoses identified by the Rome questionnaire involving the lower GI tract included: irritable bowel syndrome (IBS) in 8/30 (26.7%), functional constipation in 7/30 (23.3%), and unspecified functional bowel disorder in 6/30 (20%). CONCLUSION: Our on-going study is the first to show that there is a relationship between OSA and a wide range of GI symptoms. Interestingly, it is lower GI tract symptoms that are not only more common than upper GI tract symptoms but also more prevalent than in the general population. Future studies should further evaluate this new-found association between symptoms of GI dysmotility and OSA.

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