Impact of Laryngopharyngeal Reflux on the Levels of Depression and Anxiety in Patients With Obstructive Sleep Apnea Syndrome

Abstract

Objectives: The aim of the study was to assess the impact of the presence of laryngopharyngeal reflux (LPR) on the level of depression and anxiety in patients with obstructive sleep apnea syndrome (OSAS).

Study design: A nonrandomized, prospective clinical study.

Methods: In total, 62 patients with an apnea-hypopnea index >5 were included in this study. Each patients completed the 21-item Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Epworth Sleepiness Scale (ESS), and Reflux Symptom Index (RSI). Patients were diagnosed with LPR based on laryngeal examination and symptom presentation, with RSI score >13. The patients were divided into 2 groups based on the presence of LPR. In group A, all patients were diagnosed with LPR. In group B, the patients had no diagnosis of reflux disease.

Results: The mean RSI was 3.86 ± 2.46 in group B and 17.2 ± 6.34 in group A. The mean ESS scores did not differ between the groups (P = 0.107). Mean BAI and BDI scores were both higher in group A than in group B (P = 0.016 and P = 0.011, respectively). There was no correlation between RSI and BAI scores (r = -0.237; P = 0.063), BDI scores (r = 0.191; P = 0.138), or ESS scores (r = 0.210; P = 0.102). A positive correlation was found between RSI and apnea-hypopnea index scores (r = 0.338; P = 0.007).

Conclusion: The authors observed significantly higher levels of depression and anxiety in patients with LPR and OSAS. The authors suggest that the presence of LPR induces depression and anxiety in patients with OSAS and vice versa. Further studies involving larger numbers of patients are needed to confirm these initial findings.