Acid Reflux Disease and its Connection to OSA

Jordan Stern MD

Dr Jordan Stern in his recent article examines the impact of Acid Reflux on the ability of patients with OSA achieving and maintaining sleep. This is a very serious condition and presents in different ways for different patients.

Stomach acid can eat away at the enamel on your teeth," says Dr. Mark Castle, DDS, an ASBA Diplomate. "Your dentist may be the first to notice symptoms of the disease when he or she detects enamel loss." A refferal to a sleep specialist or a gastroenterologist for further investigation is often indicated

Dr Stern describes the condition as:

"Laryngo-pharyngeal reflux (LPR) can result in sleep disturbances by causing frightening awakenings every time a reflux episode occurs. These are frequently manifested by coughing fits and gasping for air in the middle of sleep.  The underlying mechanism of apnea is likely laryngospasm from either acid or non-acidic reflux which causes an immediate closure of the true vocal folds (the “vocal cords”) and apnea. Sleep labs, and home sleep studies rarely monitor reflux episodes.  Adding a nighttime reflux monitoring system to a home or lab sleep study would require a monitoring system that senses reflux episodes not only in the lower esophagus, but also at the level of the pharynx.  Very few laboratories are equipped for this type of testing, and few patients are willing to undergo polysomnography, much less polysomnography with a tube in the nose!"

"Foods that help you sleep? There’s no magic. Even if some foods have substances in them such as melatonin that can help us fall asleep, we would have to eat so much (cherries for example – very bad for reflux) that the side effects of eating so much of the foods would be far worse for sleep problems. Chamomile (an herbal drink), or a warm glass of low fat milk (as long as you can tolerate milk and lactose), as part of your bedtime routine can be helpful.

The BlueSleep® dietary recommendations: “low fat, low acid, low caffeine, low alcohol”,  for reflux are described by Dr. Stern and his co-authors Dr. Jamie Koufman and Chef Marc Bauer in their New York Times Best Seller:  ‘Dropping Acid: the Reflux Diet Cookbook and Cure” available at Amazon."

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