Subjects and setting
Patients with sleep disturbances and LPR symptoms were prospectively
recruited from Augustus 2019 to June 2020 from the Polyclinique Elsan
(Poitiers, France) and CHU Saint-Pierre (Brussels, Belgium). The primary
reason of patient consultation was sleep disturbance. We included those
with both sleep disturbance and LPR symptoms. All patients underwent
simultaneously 24-hour HEMII-pH (Versaflex Z®, Digitrapper pH-Z testing
System, Medtronic, Europe) and polysomnography (Cidelec LXe, Loire,
France). Only patients with confirmed diagnoses of LPR and OSAS were
included. Gastrointestinal (GI) endoscopy was proposed to patients with
GERD-related symptoms and elderly patients (>55 yo) who are
known to less feel GERD-symptoms.8 The following
exclusion criteria were considered: smoker, alcohol dependence, use of
anti-reflux treatment(s), neurological or psychiatric illness, head and
neck malignancy, history of head and neck radiotherapy, active seasonal
allergies and asthma. Symptoms of patients were evaluated with reflux
symptom score (RSS).9 A group of patients with LPR
symptoms and positive HEMII-pH without sleep disturbances was composed
throughout the same period respecting the same exclusion criteria. The
IRB approved the study protocol (n°BE076201837630). The informed consent
was obtained.