Am J Otolaryngol Head Neck Surg | Volume 5, Issue 2 | Research Article | Open Access

Autonomic Nerve Dysfunction in Patient with Laryngopharyngeal Reflux: The Study of Heart Rate Variability Finding, Risk of Having Sleep Disordered Breathing, and It's Inclination Towards Anxiety and Depression

Syahrial M Hutauruk1, Elvie Zulka Kautzia Rachmawati1*, Khoirul Anam1, Susyana Tamin1, Fauziah Fardizza1, Rudi Putranto2, Muhadi2, Winnugroho Wiratman3 and Joedo Prihartono4

1Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine University of Indonesia, Indonesia
2Department of Internal Medicine, Faculty of Medicine University of Indonesia, Indonesia
3Department of Neurology, Faculty of Medicine University of Indonesia, Indonesia
4Department of Community Medicine and Biostatistics, Faculty of Medicine University of Indonesia, Indonesia

*Correspondance to: Elvie Zulka Kautzia Rachmawati 

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Abstract

Background: Altered vagal nerve activity caused by impaired autonomic regulation was thought to be responsible for esophageal sphincter dysfunction in Gastroesophageal Reflux Disease (GERD). Yet the role of Autonomic Nerve Dysfunction (AND) in the pathogenesis of Laryngopharyngeal Reflux (LPR) remains unclear. LPR and AND is also thought to be associated with other entities, such as anxiety-depression and Sleep-Disordered Breathing (SDB).

Aim: To determine the proportion and characteristics of AND based on Heart Rate Variability (HRV) analysis in patients with LPR and control group. Other risk factors that might contribute to the incidence of LPR and AND, such as the risk of SDB and anxiety-depression, were also assessed.
Methods: Forty subjects were enrolled in the LPR group and 33 subjects as control. Fiberoptic laryngoscopy, HRV analysis, SDB risk assessment (ESS and PSQI questionnaire), and anxietydepression status (HADS questionnaire) were performed on both groups.

Result: The difference in proportion of AND between LPR and the control group was significant (p=0.001). The proportion of AND in the LPR group was 71.4%. The difference in the risk of SDB based on ESS and PSQI was significant in the LPR group compared to control group (p ≤ 0.05). The status of anxiety based on HADS in the LPR group was also significantly different compared to control (p=0.001).

Conclusion: The proportion of AND in the LPR group was greater than control. HRV findings were characterized by reduction of SDNN and LF/HF ratio, with the domination of parasympathetic properties. The risk of SDB and the inclination towards anxiety-depression were related to LPR and AND.

Keywords:

Autonomic nerve dysfunction; Heart rate variability; HRV; LPR; SDB

Citation:

Hutauruk SM, Rachmawati EZK, Anam K, Tamin S, Fardizza F, Putranto R. Autonomic Nerve Dysfunction in Patient with Laryngopharyngeal Reflux: The Study of Heart Rate Variability Finding, Risk of Having Sleep Disordered Breathing, and It's Inclination Towards Anxiety and Depression. Am J Otolaryngol Head Neck Surg. 2022;5(2): 1175..

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