NAP STUDIES UNDERESTIMATE THE INCIDENCE OF GASTROESOPHAGEAL REFLUX

Shorter nap (1 and 4 hr) pH studies inaccurately diagnosed gastroesoph ageal reflux (GER) in a group of infants evaluated for apparent life t hreatening events (ALTE) and recurrent apnea. Twenty-five infants with a postconceptional age of 42 +/- 8 SD weeks, were evaluated by 12-hr polysomnography (PSG). Prior to the start of the 12-hr study, a 1-hr T uttle Test was performed. By means of the 12-hr study 11 infants were diagnosed as having GER while the Tuttle Test incorrectly diagnosed 6 infants, 5 as having no GER and 1 as having GER when no GER was presen t (P < 0.05). No differences in the amount of periodic breathing (PB) or apnea density (AD) were found between the two studies. In addition, the first 4 hr of the 12-hr PSG segment following the first feeding w as evaluated separately. In the 4-hr segment, two of the infants were incorrectly diagnosed as not having GER. In this study, nap studies fa iled to diagnose all of the infants with GER. Therefore, we conclude t hat an infant cannot be accurately diagnosed as not having GER without prolonged pH recording. Pediatr Pulmonol. 1994; 18: 258-260. (C) 1994 Wiley-Liss, Inc.