Gastrointestinal Function, Reflux, and Airway–Sleep Interaction

OSA can worsen nocturnal reflux through pressure swings and arousals—and effective airway treatment can reduce GERD burden in many cases.

  • The Impact of Obstructive Sleep Apnea on Nocturnal Gastroesophageal Reflux.

    Shepherd KL, Holloway RH, Hillman DR, Eastwood PR.

    Demonstrates that obstructive sleep apnea increases nocturnal reflux events via intrathoracic pressure changes and arousal-related mechanisms.

    [American Journal of Gastroenterology (2007)]

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  • Nasal CPAP Reduces Gastroesophageal Reflux in Obstructive Sleep Apnea Syndrome.

    Kerr P, Shoenut JP, Millar T, Buckle P, Kryger MH.

    Shows reduction in nocturnal GERD with effective airway treatment, supporting causality rather than coincidence.

    [Chest (1992)]

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  • Marked Improvement in Nocturnal Gastroesophageal Reflux After CPAP for Obstructive Sleep Apnea.

    Green BT, Broughton WA, O’Connor JB.

    Demonstrates significant improvement of GERD symptoms with treatment of sleep-disordered breathing.

    [American Journal of Gastroenterology (2003)]

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  • Gastroesophageal Reflux in Obstructive Sleep Apnea: A Systematic Review.

    Shepherd KL, James AL, Musk AW, Hillman DR, Eastwood PR.

    Synthesizes evidence linking OSA with GERD and outlines shared pathophysiologic mechanisms.

    [Sleep Medicine Reviews (2011)]

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  • Predictors of Heartburn During Sleep in a Large Prospective Cohort Study.

    Fass R, Quan SF, O’Connor GT, Ervin A, Iber C.

    Identifies sleep-disordered breathing and arousal-related factors as predictors of nocturnal reflux symptoms.

    [Chest (2005)]

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  • The Effect of Sleep on Gastroesophageal Reflux: Clinical Implications.

    Orr WC, Fass R, Sundaram SS, et al.

    Reviews how sleep stage, arousals, and airway resistance influence reflux severity and esophageal clearance.

    [American Journal of Gastroenterology (2009)]

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  • Mechanisms Linking Obstructive Sleep Apnea and Gastroesophageal Reflux Disease.

    Shepherd KL, Eastwood PR.

    Explains negative intrathoracic pressure swings, arousal physiology, and autonomic factors connecting OSA and GERD.

    [Sleep Medicine Clinics (2010)]

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  • Association Between Obstructive Sleep Apnea and Gastroesophageal Reflux Disease: A Meta-Analysis.

    Wang Y, et al.

    Quantifies increased GERD risk in patients with OSA across observational studies.

    [Sleep & Breathing (2019)]

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  • Sleep-Related Gastroesophageal Reflux and Its Relationship With Sleep Disturbance.

    Jung HK, et al.

    Shows bidirectional relationship between reflux severity and sleep fragmentation.

    [Journal of Neurogastroenterology and Motility (2013)]

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  • The Montreal Definition and Classification of Gastroesophageal Reflux Disease.

    Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R.

    Provides standardized GERD definitions frequently cited in sleep–reflux research and clinical guidelines.

    [American Journal of Gastroenterology (2006)]

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https://pubmed.ncbi.nlm.nih.gov/17391315/
https://pubmed.ncbi.nlm.nih.gov/1398519/
https://pubmed.ncbi.nlm.nih.gov/12738463/
https://pubmed.ncbi.nlm.nih.gov/21474303/
https://pubmed.ncbi.nlm.nih.gov/15653973/
https://pubmed.ncbi.nlm.nih.gov/19319130/
https://pubmed.ncbi.nlm.nih.gov/20451038/
https://pubmed.ncbi.nlm.nih.gov/30506136/
https://pubmed.ncbi.nlm.nih.gov/24044042/
https://pubmed.ncbi.nlm.nih.gov/16928254/