Sleep-related laryngospasm caused by gastroesophageal reflux.

Gastroesophageal reflux is a suspected cause of sleep-related laryngospasm [Thurnheer R, Henz A, Knoblauch A. Sleep-related laryngospasm. Eur Respir J 1997;10:2084-6], but the relationship has not been directly documented by polysomnography (PSG). We report the case of an eight-year-old girl with asthma who was referred for evaluation of awakenings with respiratory distress. The description of her events included stridorous breathing suggestive of laryngospasm. A PSG was performed with esophageal pH monitoring, and during the recording pH dropped below four on nine occasions. Following two of the pH drops, acute respiratory distress with stridor was documented in video and audio recording, supporting a causal relationship between sleep-related gastroesophageal reflux and laryngospasm.