The study included 89 adults aged 18 to 75 years diagnosed with both moderate-to-severe OSA and GERD. Patients were prescribed auto-titrating CPAP therapy, and adherence was defined as using the device for more than four hours per night on at least 70% of nights over one month. Clinical assessments, including GERD symptom scores, daytime sleepiness scales, and polysomnographic measures, were conducted at baseline and repeated after one month of therapy.
Based on the study, the researchers reported the following findings:
- 72 patients (80.9%) demonstrated adequate CPAP adherence.
- Significant reductions in GERD symptoms were observed, as measured by the GERD-Q questionnaire.
- Improvements were noted in apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and daytime sleepiness scores.
- No adverse effects from CPAP use were reported during the study period.
- CPAP improved GERD outcomes independent of changes in sleep apnea severity or oxygen levels, suggesting a possible direct therapeutic effect on reflux mechanisms.
The researchers further observed that smoking and adopting right-sided or supine sleep positions reduced the extent of GERD relief, whereas patients who showed greater improvement in daytime sleepiness were more likely to experience stronger benefits. Based on these observations, the authors emphasized the importance of patient education and telemedicine-based support during the first month of CPAP use, which they described as a critical period for habit formation and long-term adherence. They also highlighted the need to address modifiable risk factors such as smoking and sleep positioning to maximize therapy outcomes.
"The findings highlight the potential of CPAP as a frontline treatment option for patients with both OSA and GERD, even in cases where reflux symptoms may not directly correlate with apnea severity. The use of validated assessment tools like the GERD-Q and Epworth Sleepiness Scale (ESS) was recommended to help clinicians monitor treatment response and personalize therapy more effectively," the authors wrote.
At the same time, the authors acknowledged limitations, including the non-randomized single-center design, relatively small sample size, and short one-month follow-up, which may limit generalizability and long-term applicability. The exclusion of patients on proton pump inhibitors (PPIs) was also noted as a factor that could reduce the relevance of the findings to typical GERD populations.
"Overall, the study provides valuable evidence that consistent CPAP use can deliver dual benefits by improving both sleep-related outcomes and reflux symptoms in patients living with OSA and GERD. Strengthening early adherence support, integrating lifestyle modifications, and tailoring patient counseling could further enhance the effectiveness of this therapy in routine clinical practice," they concluded.
Reference:
Saha S, Meher M (August 25, 2025) Impact of Continuous Positive Airway Pressure Therapy on Gastroesophageal Reflux Disease in Patients With Obstructive Sleep Apnea: A Prospective Cohort Study. Cureus 17(8): e90927. doi:10.7759/cureus.90927
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