Gastroesophageal reflux is common. It occurs when stomach acid moves up into the esophagus and causes burning, erosions or ulcerations. If the acid moves higher, it may enter the larynx or even the lungs, causing cough, wheezing or shortness of breath. Many patients with nighttime cough suffer from reflux, and are treated with antacids and proton pump inhibitors.

It now appears people with nocturnal reflux should also be evaluated for sleep apnea. During sleep apnea, tissues in the back of the throat, including the tongue, fall backward and occlude the airway. The body struggles to get enough air, leading to a tightening of abdominal muscles, and forcing the stomach up against the diaphragm. This pushes stomach contents up through the gastroesophageal sphincter (valve) into the esophagus, thus causing reflux.

Treatment for sleep apnea may also eliminate reflux. If you know of someone who is awakened by nighttime coughing, and doesn’t get a good night’s sleep, suggest evaluation for sleep apnea. The diagnosis will be missed unless specifically looked for.

Allan Sosin

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