Is heartburn and reflux a symptom of obstructive sleep apnea?

Heart burn (GERD). There is some controversy over this – but anecdotally I have seen this far too frequently to believe it to be just a co-incidence.

As the airway closes the diaphragm is still dropping to pull in outside air – but due to the obstruction, it can’t, so it causes the chest pressure to drop, potentially pulling up acid from the stomach.

Unexplained chronic heartburn

As the chest cavity pressure drops – if it can’t pull in outside air due to an obstruction in the wind pipe (pharynx), it may pull up (or reflux) acid from the stomach into the food pipe (esophagus), causing a burning sensation, or heart burn.

Millions of people are consuming millions of antacid tablets due to a potentially missed diagnosis – but it keeps the manufacturers profitable!

Connection between heartburn and cancer

Heartburn, the burning sensation caused when stomach acid escapes up into the oesophagus can be worsened by scarring or damage to the area where the oesophagus joins the stomach.

In a small proportion of people chronic acid-reflux can start to irritate and damage cells lining oesophagus, which may eventually cause the cells to change shape and grow abnormally.

These cells start looking more like cells from the stomach and less like oesophageal cells – a condition called Barrett’s oesophagus.

Most people with Barrett’s oesophagus can manage their condition through monitoring, treatments, and lifestyle changes,  but experts warn that if Barrett’s goes undetected, the cells can sometimes continue to change until tumours develop.

Experts argue just five to ten per cent of people with persistent acid-reflux will develop Barrett’s, and just 5 to 10 per cent of those will go on to develop oesophageal cancer.

But the disease can be tough on those that do. Although oesophageal cancer survival is improving in this country and has tripled since the 1970s, still fewer than two in  ten patients will survive ten or more years.

Damaged oesophageal cells change from being a healthy cell, to a Barrett’s cell, to a cancerous cell.

Connection between Barrett’s oesophagus and obstructive sleep apnea (OSA).

Most of the doctor’s I’ve spoken with, indeed much of the literature too, discredit any connection between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA) crediting instead, a co-incidental relationship.

Yet it was strongly believed that a strong relationship existed between GERD and alcohol consumption.

Perhaps surprisingly the relationship existed between GERD and alcohol consumption has not proven to be strong. On the other hand a recent study by GMC Gastroenterology fount and reported the following account. Quote:

“In this pilot study, a high proportion of Barrett’s esophagus subjects scored at high risk for obstructive sleep apnea. Having Barrett’s esophagus was associated with more severe gastroesophageal reflux symptoms, and nocturnal reflux symptoms were associated with scoring at high risk for obstructive sleep apnea. “

It goes on to say,”The need for obstructive sleep apnea screening in Barrett’s esophagus patients with nocturnal gastroesophageal reflux symptoms should be further evaluated.”

Why do I get repeated sinus or nasal problems?

Repeated sinus problems, congestion. When this acid regurgitation occurs, it acidifies the mucous and saliva fluids covering and protecting the mouth, nose, throat and sinuses.

All of these then show some evidence of inflammation (not due to infection or allergy, but more so due to response to low grade chronic acid exposure.

It is not beyond the realms of possibility that such low grade chronic inflammation may be attributed to allergies and many people take long courses of steroid containing nasal sprays – steroids may act as an immunosuppressant.

Steroid drugs, such as prednisone, work by lowering the activity of the immune system. The immune system is your body’s defense system. Steroids work by slowing your body’s response to disease or injury. 

Acid attack on teeth – no bacteria required!

Another frequently misdiagnosed area both by doctors and dentists – is tooth damage (since teeth and acids don’t mix well) – especially causing pitting on their biting surfaces.

“If you think about it, teeth get worn due to grinding. Teeth don’t touch during chewing. Enamel is the hardest substance in the body and stronger than most materials used to restore teeth.

When teeth wear it is usually the teeth that wear each other – therefore a position where the opposing teeth fir one another can be found – like a jigsaw puzzle. If this is the case how can it possibly be that pitting – that is areas of tooth loss BELOW the worn level can exist?

Acid deminearlises tooth substance – just like decay does – the difference is that this is on smooth surfaces. Decay requires plaque, diet and bacteria, direct acid attack needs acid – stomach acid is hydrochloric acid, an extremely potent and powerful acid.

Good sleep is crucial to good health and longevity.

Dr. Stephen Bray 2019

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