Laryngopharyngeal reflux induced sleep‑related laryngospasm

Background Sleep-related laryngospasm (SRL) has been defned as the sustained closure of the vocal cords during sleep. Studies have suggested that it is a rare manifestation of laryngopharyngeal refux (LPR). Difculties in diagnosing SRL and LPR have led to the condition being under-recognised in the clinical setting. Aims The aim of this study was to determine if LPR was the cause of the SRL symptoms seen in our patients. Methods A retrospective chart assessment of patients with SRL. Patients with risk factors for LPR were identifed. These included smoking status, alcohol intake, a history of dyspepsia or history of gastroesophageal refux disease, a history of late-night eating and a history of eating spicy or fatty foods before bed. A clinical diagnosis based on the history and response to management was made for the diagnosis of LPR. All were advised to refrain from late meals and those with signs of nasopharyngitis were commenced on proton pump inhibitor therapy. Results Nineteen patients (mean age±SD: 57.21±15.18) were included in the study. All had at least one risk factor for LPR. Ten (52.6%) had signs of nasopharyngitis on nasendoscopy. Following treatment, 17 (89.5%) reported no further SRL symptoms at 1-year follow-up. Conclusion SRL is a largely unknown and under-diagnosed condition. We believe this study provides supportive evidence for the causal relationship between LPR and SRL.