GOR(D) and apnoea

Several mechanisms can contribute to respiratory manifestations in patients with gastro-oesophageal reflux (GOR), but pathological and causal relationship is uncommon. In most infants apnoea of short duration is a physiologic phenomenon occurring frequently in relation to an episode of GOR and a protective mechanism to prevent aspiration. Diagnostic gold standard, cut-off values and follow-up data are currently lacking making the relation between GOR or GOR disease and respiratory system difficult to clarify. When compared with pH monitoring, oesophageal impedance with simultaneous polysomnography can better demonstrate the temporal association in selected patients but should be reserved to severe or recurrent otherwise unexplained respiratory events. Empirical treatment for GOR is not recommended due to lack of evidence of efficacy and possible pharmacologically related adverse events.