O'Connor-Reina, CarlosGarcia, Jose Maria IgnacioBaptista, PeterGarcia-Iriarte, Maria TeresaAlba, Carlos CasadoPerona, MonicaBorrmann, Paz FranciscaAlcala, Laura RodriguezPlaza, Guillermo2023-02-092023-02-092021-06-30http://hdl.handle.net/10668/18063We present the first case of a patient with obstructive sleep apnea syndrome (OSA), where drug induced sleep endoscopy was helpful to suspect a non-acid reflux disease and showed an improvement in a swollen epiglottis after treatment. Patient ameliorated significantly his disease only with medical therapy. A 54-year-old man without significant anatomical findings with obstructive sleep apnea syndrome and non-acid gastroesophageal reflux disease (GERD) disease whose Apnea- hypopnea index (AHI) was significantly reduced with the intake of 500 mg of sodium alginate twice a day for 6 months. Conventional digestive tests such as esophagoscopy and simple- and double-channel 24-h pH-metry suggested mild GERD. Conventional proton-pump inhibitor treatment with pantoprazole (40 mg daily) was started without any improvement in his sleep. Multichannel intraluminal 24-h impedanciometry indicated the presence of severe pathological GER of gaseous origin. The patient's AHI decreased from 25.3 at baseline to 8 after treatment with sodium alginate. A drug-induced sleep endoscopy study showed the changes before and after this treatment and was helpful for the diagnosis. Thus, medical treatment can be a therapeutic option in some patients with OSA. Multichannel 24-h impedanciometry should be performed when nonacid GERD is suspected.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Continuous positive airway pressureDrug-induced sleep endoscopyEpiglottisMultichannel impedanciometryNonacid reflux diseaseObstructive sleep apneaEsophagoscopyGastroesophageal RefluxHumansMaleMiddle AgedPolysomnographyProton Pump InhibitorsSleepSleep Apnea Syndromesresearch article34193270open access10.1186/s40463-021-00526-w1916-0216PMC8247236https://doi.org/10.1186/s40463-021-00526-whttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8247236/pdf