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Eur Arch Otorhinolaryngol. 2018 Jan;275(1):219-224. doi: 10.1007/s00405-017-4812-4. Epub 2017 Nov 22.

Relationship between the severity of laryngopharyngeal reflux and sleep apnea: using drug-induced sleep endoscopy (DISE).

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Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University School of Medicine, Daegu, South Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea.



The aim of the study is to identify the following associations: (1) severity of obstructive sleep apnea syndrome (OSAS) and laryngopharyngeal reflux (LPR)-related clinical parameters, such as reflux finding score (RFS), reflux symptom index (RSI), and LPR-health-related quality of life (LPR-HRQOL) and (2) complete obstruction on drug-induced sleep endoscopy (DISE) and LPR-related clinical parameters.


Subjects included the OSAS patients without surgery history and all patients perform the polysomnography (PSG) and DISE for their OSAS. Demographics, polysomnographic data, DISE results, and LPR-related parameters were collected prospectively. The patients were divided into age-, sex-, and BMI-matched two groups, according to numbers of complete obstruction on DISE (complete obstruction at 0-1 subsites (unilevel) vs. 2-4 subsites (multilevel). Finally, 19 patients with unilevel complete obstruction and 38 patients with multilevel complete obstruction were compared. The multiple linear regression analysis was employed to determine the predictors of LPR-related quality of life.


Among 88 patients, 19 patients demonstrated unilevel complete obstruction, and 69 patients demonstrated multilevel complete obstruction on DISE. There were no significant correlation between OSAS severity and RFS, RSI, and scores of LPR-HRQOL. Multilevel complete obstruction on DISE did not affect the LPR-related clinical parameters (pā€‰>ā€‰0.05). The result of multiple linear regression demonstrated complete obstruction at the epiglottis had a strong influence on the high scores of LPR-HRQOL.


LPR is commonly developing disease with OSAS, but the OSAS severity did not affect the LPR-related parameters. The multilevel complete obstruction on DISE was not associated with the LPR-related clinical parameters.


Drug-induced sleep endoscopy; Extra-esophageal reflux syndromes; Laryngopharyngeal reflux; Obstructive sleep apnea

[Indexed for MEDLINE]

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