%PDF-1.2 % 2 0 obj << /Length 16340 >> stream 0 g /GS2 gs 1 i 391.011 640.12 0.51 -208.176 re f BT /F1 1 Tf 14.944 0 0 14.944 70.186 720.34 Tm 0.0209 Tc [(Arousal)-335.4(i)2.2(n)-332.5(p)-2.4(atients)-333.8(w)1.4(ith)-332.5(g)-2.4(astro-oesophageal)-331.6(reflux)-330(and)-332.5(s)0(leep)]TJ 13.4031 -1.0319 TD (apnoea)Tj /F2 1 Tf 10.959 0 0 10.959 108.17 667.559 Tm 0 Tc [(T.)-336.2(Penzel,)-326.1(H.F.)-335.7(Becker,)-330.4(U.)-330.5(Brandenburg,)-328.9(T.)-331.1(Labunski,)-329.7(W.)-334.3(Pankow,)-327.9(J.H.)-330.7(Peter)]TJ /F3 1 Tf 8.966 0 0 8.966 58.28 630.708 Tm [(Ar)27.9(ousal)-462.6(in)-463(patients)-471.9(with)-462.7(gastr)29.4(o-oesophageal)-465.3(r)30.9(eflux)-469.7(and)-466.4(sleep)-462.2(apnoea.)-467.5(T)77.8(.)-464.5(Penzel,)-468(H.F)124.1(.)]TJ 0 -1.0559 TD [(Becker)100.5(,)-325.4(U)0(.)-328.2(Brandenbur)31.1(g,)-324.9(T)71.5(.)-325.4(Labunski,)-329.5(W)82.2(.)-325.4(Pankow)71(,)-325.4(J.H.)-330.3(Peter)103.4(.)]TJ /F4 1 Tf 25.26 0 TD 0 Tw (#)Tj /F3 1 Tf 0.999 0 TD [(ERS)-327.9(Journals)-329.3(Ltd)-328.2(1999.)]TJ /F5 1 Tf -26.259 -1.0559 TD [(ABSTRACT)66.7(:)-240.7(Nocturnal)-245.3(gastro-oesop)10(hageal)-244.3(reflux)-238.7(has)-238.5(been)-247.6(observed)-240.2(in)-246.6(patients)-245(with)]TJ T* [(obstructive)-280.9(sleep)-277.4(apnoea)-278.4(\(OSA\).)-284.2(Negative)-274(intrathoracic)-287.2(pr)15.3(essure)-269.1(during)-279.4(apnoeas)-279.1(and)]TJ T* [(arousal)-320.8(have)-337.8(been)-329.8(suggested)-336.9(as)-335.3(the)-332.9(underlying)-335(mechanisms.)]TJ 0.999 -1.0559 TD [(In)-371.8(order)-368.4(to)-373(evaluate)-370.4(this)-367.8(hypothesis,)-372.1(the)-370.9(coincidence)-373.1(and)-368.7(sequence)-371.3(in)-366.7(time)-374.6(of)-366.7(ar)26.5(-)]TJ -0.999 -1.0559 TD [(ousal,)-350.3(apnoea)-341.6(and)-349.7(r)13.4(eflux)-353.2(events)-345(were)-342(analysed.)-347.1(Fifteen)-350.1(patients)-346.1(with)-351(OSA)-350(or)-346.5(heavy)]TJ T* [(snoring)-306.8(wer)11.3(e)-309.1(studied)-306.3(by)-301.1(means)-307.3(of)-303.5(standard)-309.7(polysomnograpy)-308.5(with)-306.7(parallel)-304.7(record)11.7(ing)]TJ T* [(of)-335.1(24-h)-332.6(oesophageal)-336.1(pH.)]TJ 0.999 -1.0559 TD [(Reflux)-299.1(events)-294.4(during)-292(the)-295(day)-294.2(wer)11.3(e)-296.5(presen)11.7(t)-297.6(i)0(n)-297.1(all)-294.1(patients,)-292.1(five)-298.3(of)-297.1(whom)-291.2(had)-292.8(symp-)]TJ -0.999 -1.0559 TD [(toms)-215.6(of)-214.9(reflux.)-203.7(In)-220.1(thr)14.8(ee)-219.8(of)-214.9(these)-212.7(and)-217(in)-214.9(five)-216.1(other)-217.9(patients,)-216.2(a)-214.5(total)-216.7(of)-214.9(69)-214(nocturnal)-215.3(r)13.4(eflux)]TJ T* [(events)-345(wer)11.3(e)-347(found.)-344.8(In)-340.2(68)-346.8(events,)-341.6(arousal)-333.5(was)-344.4(found)-348.3(with)-344.6(the)-345.6(r)13.4(eflux)-346.9(event.)-347.2(Only)-342.2(one)]TJ T* [(reflux)-346.2(without)-355.3(arousal)-346.1(was)-357(found)-354.6(\(sleep)-360(stage)-353.5(2\).)-356.9(Seventeen)-357.9(events)-357.6(occurr)11.7(ed)-357.8(during)]TJ T* [(wakefulness)-321.2(after)-321.4(sleep)-315.3(onset.)-323.3(The)-317.7(perce)11.2(ntage)-319.2(of)-316.1(time)-324(with)-319.3(a)-315.7(p)0(H)-315.6(o)0(f)]TJ /F6 1 Tf 28.921 0 TD (<)Tj /F5 1 Tf 0.5501 0 TD [(4)-315.7(during)-317.3(wake-)]TJ -29.4711 -1.0559 TD [(fulness)-220.4(after)-226.6(sleep)-220.5(onset)-219.3(was)-224.3(significantly)-224.3(higher)-217.3(than)-223.7(the)-219.1(percentage)-213.2(of)-221.3(time)-222.8(with)-224.5(a)-220.8(p)0(H)]TJ T* (of)Tj /F6 1 Tf 1.1634 0 TD (<)Tj /F5 1 Tf 0.5564 0 TD [(4)-340.9(during)-342.6(total)-343.2(sleep)-340.6(time)-349.3(\(p)]TJ /F6 1 Tf 11.7986 0 TD (<)Tj /F5 1 Tf 0.5501 0 TD [(0.05\).)-346.2(In)-340.2(37)-340.4(of)-347.7(the)-339.2(52)-340.4(reflux)-339.9(events)-338.7(which)-347.8(occurr)11.7(ed)]TJ -14.0685 -1.0559 TD [(during)-298.3(sleep,)-299.2(either)-301.7(an)-294.8(apnoea)-297.4(or)-295.9(a)-296.7(hypopnoea)-299.3(was)-293.8(found)-297.7(prior)-301.5(to)-297.1(the)-295(event.)-302.9(The)-298.7(in-)]TJ T* [(vestigation)-367.4(of)-360.4(sequence)-358.7(in)-360.4(time)-368.3(did)-358.4(not)-364.8(prove)-349.7(a)-359.9(causal)-359.3(relation)-353.9(between)-363.9(respiratory)]TJ 0 -1.0496 TD [(events)-332.3(and)-337.1(r)13.4(eflux)-334.3(events.)]TJ 0.999 -1.0559 TD [(The)-210.2(results)-209(indicate)-213.3(that)-213.5(gastr)13.3(o-oesophageal)-215.9(r)13.4(eflux)-214.1(and)-210.6(obstructive)-217.7(sleep)-214.1(apnoea)-208.9(ar)13.9(e)]TJ -0.999 -1.0559 TD [(two)-331.5(separate)-337.4(disorders,)-334.7(which)-335.2(both)-337.5(have)-331.4(a)-334.6(high)-332.6(prevalen)11.5(ce)-333.7(in)-335.1(obese)-331.9(patients.)]TJ /F3 1 Tf T* [(Eur)-331.9(Respir)-333.8(J)-334.4(1999;)-333.5(14:)-334.6(1266\2611270.)]TJ /F7 1 Tf 7.97 0 0 7.97 401.499 631.672 Tm [(Medizinisch)11.6(e)-615.7(Poliklinik,)-606.5(Philips-Unive)10(r-)]TJ 0 -1.0599 TD (sita)Tj 0.9887 0 TD [(\310)-47.9(t)0(,)-333.6(M)-0.1(arbur)14.2(g,)-331.2(German)11.7(y)59(.)]TJ -0.9887 -2.1268 TD [(Corresponde)11.8(nce:)-333.4(T)77.6(.)-333.3(Penzel)]TJ 0 -1.0599 TD [(Medizinisch)11.6(e)-487.7(Poliklinik)-486.6(der)-490.8(Philips-)10.5(Uni-)]TJ 0 -1.067 TD (versita)Tj 2.2406 0 TD 0.055 Tc (\310t)Tj -2.2406 -1.0599 TD 0 Tc [(Baldinger)11.3(str)52.3(.)-333.3(1)]TJ T* [(D-35033)-322.3(Marbur)14.2(g)]TJ 0 -1.067 TD (Germany)Tj 0 -1.0599 TD [(Fax:)-325.1(49)-330.1(64212865450)]TJ 0 -2.1268 TD [(Keywords)11.5(:)-334.6(Arousal)]TJ 0 -1.0599 TD [(gastro-oes)10.8(ophageal)-331.1(reflux)]TJ 0 -1.067 TD [(pH)-332.6(recording)]TJ 0 -1.0599 TD [(polysomn)13(ography)]TJ T* [(sleep)-325.4(apnoea)]TJ 0 -2.1268 TD [(Received:)-327.9(April)-324.1(23)-330.1(1998)]TJ 0 -1.067 TD [(Accepted)-325.4(after)-331.6(revision)-329.8(June)-326.1(29)-330.1(1999)]TJ 9.963 0 0 9.963 68.258 405.751 Tm [(Ga)16.9(st)17.7(ro)13.9(oe)20.8(so)14.4(ph)21.2(ag)15.1(ea)20.4(l)-202.3(r)0(e)13.5(f)0(l)17.3(u)0(x)-189.3(d)0(i)13.2(s)0(o)20(r)0(d)19.6(e)0(r)-197(i)0(s)-192.9(c)0(h)15.1(a)0(r)19.2(a)0(c)20.4(t)0(e)12.8(r)0(i)17.3(z)0(e)20.4(d)-205.6(by)-189.3(an)]TJ -1.0015 -1.0528 TD [(in)18.9(cr)13.5(ea)20.4(se)13.9(d)-353.6(n)0(u)21.2(m)0(b)12.4(e)0(r)-345(a)0(n)15.1(d)-353.6(du)15.5(ra)19.2(ti)16.5(on)-343(of)-350.2(ga)20.8(st)17.7(ro)13.9(-o)19.6(es)19.6(op)15.5(ha)15.1(ge)20.8(al)-345.7(re)13.5(-)]TJ T* [(fl)17.3(ux)-200.7(ev)20.8(en)15.1(ts)-198.6([1)13.9(].)-219(An)-221.7(underl)-9(ying)-221.7(reflux)-226.8(disease)-221.9(is)-221.3(assum)-9.7(ed)-218.2(if)]TJ T* [(the)-420.5(percentage)-423.3(o)-6.5(f)-412.1(time)-421.1(wi)-7.8(th)-413.6(a)-416.6(p)0(H)-420.9(o)0(f)]TJ /F6 1 Tf 15.649 0 TD (<)Tj /F7 1 Tf 0.552 0 TD [(4)-416.2(i)0(n)-419.3(the)-414.8(uprig)-7.8(ht)]TJ -16.201 -1.0471 TD (position)Tj /F6 1 Tf 3.5281 0 TD (>)Tj /F7 1 Tf 0.552 0 TD [(10.5)-327(or)-321.8(if)-324.2(the)-329.4(percentage)-332.3(of)-327.5(time)-324.3(wi)-7.8(th)-322.6(a)-325.5(p)0(H)-324.1(o)0(f)]TJ /F6 1 Tf -4.0801 -1.0527 TD (<)Tj /F7 1 Tf 0.552 0 TD [(4)-211.3(i)0(n)-214.5(the)-215.6(supine)-213.4(posit)-9.8(ion)]TJ /F6 1 Tf 9.3382 0 TD (>)Tj /F7 1 Tf 0.5577 0 TD [(6)-211.3([2].)-210.7(The)-217.4(prevalence)-218.5(o)-6.5(f)-207.2(gastr)-9.4(o-)]TJ -10.4478 -1.0527 TD [(oesopha)-7.3(geal)-256.6(refl)-9(ux)-251.9(disor)-9(der)-254.7(is)-255.5(5%)-254.3(of)-253.5(the)-261.2(adult)-253.7(popu)-8.7(lation)]TJ 0 -1.0471 TD [([3],)-313.1(and)-310(thus)-313.9(is)-312.4(similar)-314.7(to)-311.2(the)-312.4(preval)-9.4(ence)-311.6(of)-310.4(sleep-rel)-11.5(ated)]TJ 0 -1.0528 TD [(breat)-8.6(hing)-210.3(disord)-9.7(ers)-210.3([4].)-210.7(In)-213.7(healthy)-215.8(adults,)-216.2(very)-209.9(few)-213.1(gastr)-9.4(o-)]TJ T* [(oesopha)-7.3(geal)-222.5(refl)-9(ux)-217.8(events)-225.2(are)-226.6(found)-221.7(durin)-7.8(g)-217(the)-221.3(night)-224.8(\(eig-)]TJ 0 -1.0471 TD [(ht)-345.3(times)-343.4(less)-349.7(than)-341.6(durin)-7.8(g)-342.2(the)-340.8(dayti)-9(me\))-343.2([5\2617].)-348.8(In)-344.6(patients)]TJ 0 -1.0528 TD [(with)-387.3(a)-382.4(gastro-oes)-10.7(ophageal)-391(refl)-9(ux)-382.8(disease,)-387.3(in)-385.2(addition)-389.2(to)]TJ T* [(daytime)-236(events)-9(,)-222.3(noctur)-9(nal)-232.7(events)-230.9(are)-232.3(also)-229(found.)-233.4(Nocturn-)]TJ T* [(al)-357.1(gastro-oes)-10.7(ophageal)-362.5(refl)-9(ux)-354.3(is)-357.9(clinical)-11.1(ly)-356.7(very)-357.9(importan)-10.3(t)]TJ 0 -1.0471 TD [(because)-389.4(even)-9.6(ts)-380.7(usual)-7.8(ly)-385.2(last)-390.7(longer)-390.2(than)-387.1(during)-389.8(the)-386.3(day-)]TJ 0 -1.0527 TD [(time.)-336.1(This)-335.1(is)-329.5(due)-332.7(to)-334(the)-335.1(fact)-332.2(that)-332.6(oesopha)-7.3(geal)-336.3(motili)-11.6(ty)-328.3(is)]TJ T* [(reduced)-258.5(at)-254.7(night)-259(and)-253.1(the)-255.5(supine)-258.9(body)-253.4(position)-259.1(also)-257.4(causes)]TJ 0 -1.0471 TD [(prolo)-7.8(nged)-430.2(oesopha)-7.3(geal)-433(clear)-9(ance.)-437.1(In)-429.9(addition,)-435.1(the)-437.6(time)]TJ 0 -1.0528 TD [(course)-429.3(of)-424.2(reflux)-426(events)-430.1(durin)-7.8(g)-421.9(wakefulne)-10.3(ss)-425(and)-423.8(durin)-7.8(g)]TJ T* [(sleep)-252.9(are)-249.4(very)-249.7(different.)-245.2(T)57.7(ypically)54.2(,)]TJ /F6 1 Tf 13.7825 0 TD (>)Tj /F7 1 Tf 0.552 0 TD [(80%)-249.3(of)-247.8(the)-249.8(refl)-9(ux)-246.2(ev-)]TJ -14.3345 -1.0471 TD [(ents)-337.1(occur)-336.3(durin)-7.8(g)-330.8(wake)-7.8(fulne)-8.2(ss)-334(in)-334(the)-335.1(uprig)-7.8(ht)-334(body)-333.1(posi-)]TJ 0 -1.0528 TD [(tion)-428.9(after)-431.3(a)-422.3(meal)-9.4(,)-421.5(and)-429.5(are)-425.8(clear)-9(ed)-428.7(rather)-432.1(quickly)-431.6(under)]TJ T* [(these)-235.8(condition)-8.7(s.)-230(Rep)-7.4(orts)-230.1(conce)-10.7(rning)-229.7(refl)-9(ux)-229.2(events)-236.6(durin)-7.8(g)]TJ T* [(sleep)-543.1(differ)-535.7(widely)54.6(.)-541(Some)-540.7(studies)-547.8(report)-545.5(that)-543.1(patients)]TJ 0 -1.0471 TD [(contin)-9.7(ue)-326.3(to)-328.3(sleep)-332.6(wi)-7.8(thout)-327.2(be)-7.6(ing)-329(disturbed)-333.5([5])-335.5(and)-327.1(other)-8.2(s)]TJ 0 -1.0527 TD [(report)-312.2(many)-302.5(awak)-7.8(enings)-310.2([8].)-307.5(Characte)-10.7(ristic)-310.8(reflux)-306.5(symp)-7.4(-)]TJ T* [(toms)-396.7(wer)-8.2(e)-393.8(reported)-399.4(if)-392.5(the)-397.7(patien)-10.1(ts)-392.1(woke)-7.4(.)-393(I)0(t)-392.5(i)0(s)-392.1(not)-397.3(clear)]TJ 0 -1.0471 TD [(whether)-355.5(reflux)-352(usually)-347.4(causes)-355.3(awakenings)-352.1(or)-350.2(only)-346.9(arou-)]TJ 0 -1.0528 TD [(sal,)-268.4(and)-270.2(furth)-9.4(ermore)-273.5(whether)-275.8(arousal)-273.1(may)-267.6(cause)-273.7(reflux.)-272.7(It)]TJ 25.1977 29.4315 TD [(is)-397.8(know)-7(n,)-393.8(however)22.5(,)-393(that)-395.2(pati)-8.2(ents)-399.7(with)-398.7(reflux)-397.5(symp)-7.4(toms)]TJ 0 -1.0528 TD [(durin)-7.8(g)-273.9(the)-278.2(day)-275.8(also)-280.2(exhibit)-280.3(more)-275.7(refl)-9(ux)-274.7(events)-282.1(during)-276(the)]TJ T* [(night)-338.6(compa)-7.8(red)-340(to)-334(norm)-7.8(al)-334.4(subjects)-344.1([6].)]TJ 1.0015 -1.0471 TD [(Pa)15.9(ti)16.5(en)15.1(ts)-403.4(w)12.4(i)0(t)16.5(h)-410.5(sl)17.7(ee)14.7(p-)19.6(re)13.5(la)18.4(te)18.4(d)-410.5(b)0(r)13.9(e)0(a)20.4(t)0(h)18.9(i)0(n)13.2(g)-410.5(di)18.9(so)20(rd)13.9(er)19.2(s)-411.7(u)0(s)14.4(u)0(a)20.8(l)0(l)16.5(y)]TJ -1.0015 -1.0528 TD [(ex)15.1(pe)15.1(ri)17.3(en)20.8(ce)-247(mu)12.4(lt)22.2(ip)13.2(le)-249(ar)19.2(ou)15.5(sa)19.6(ls)-249.8(du)21.2(ri)17.3(ng)-251.9(sl)17.7(ee)20.4(p,)-251.5(l)13.9(e)0(a)14.7(d)0(i)18.9(n)0(g)-246.2(t)0(o)-248.6(s)0(l)17.7(e)0(e)14.7(p)]TJ 0 -1.0471 TD [(fr)12.4(ag)20.8(me)17.7(nt)13.2(at)18.5(io)18.9(n)-569.8(a)0(n)15.1(d)-569.8(ex)20.8(ce)14.7(ss)18.8(iv)18.9(e)-570.2(d)0(a)15.1(y)0(t)18.9(i)0(m)15.7(e)-570.2(so)14.4(mn)18.1(ol)18.9(en)15.1(ce)20.4(.)-569.4(T)69.1(y-)]TJ 0 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[(re)19.2(co)15.1(rd)19.6(in)13.2(g)-313.7(i)0(n)-311.2(t)0(h)13.2(e)-314.2(sl)12(ee)20.4(p)-319.4(l)0(a)18.4(b)0(o)15.5(r)0(a)19.2(t)0(o)18.9(r)0(y)76.5(,)-319.1(co)20.8(de)15.1(d)-319.4(b)0(y)-308.8(d)0(i)18.9(f)20.4(fe)13.5(re)19.2(nt)-311.2(ke)15.1(ys)]TJ 25.1977 39.8338 TD [(on)-314.5(th)18.9(e)-319.8(r)0(e)19.2(c)0(o)15.1(r)0(d)19.6(e)0(r)70.4(.)-319.1(On)-312.7(in)18.9(it)16.5(ia)18.4(li)16.5(zi)18.5(ng)-308.8(th)13.2(e)-319.8(r)0(e)19.2(c)0(o)20.8(r)0(d)13.9(i)0(n)18.8(g)0(,)-308.4(t)0(h)18.8(e)-319.8(in)13.2(t)13.9(e)0(r)13.5(n)0(a)20.8(l)]TJ 0 -1.0527 TD [(cl)12.8(oc)20.8(k)-228.4(o)0(f)-219.4(t)0(h)18.9(e)-228.8(pH)-216(re)13.5(co)20.8(rd)13.9(er)-214.1(wa)11.2(s)-223.9(s)0(y)14.4(n)0(c)20.8(h)0(r)19.6(o)0(n)15.5(i)0(z)18.4(e)0(d)-218.2(w)0(i)14.9(t)0(h)-220.2(t)0(h)18.9(e)-228.8(mi)15.7(cr)19.2(o-)]TJ 0 -1.0471 TD [(co)15.1(mp)18.1(ut)18.9(er)24.9(-d)19.6(ri)17.3(ve)15.1(n)-365(c)0(l)18.4(o)0(c)15.1(k)-365(in)-356.7(th)18.9(e)-365.4(s)0(l)17.7(e)0(e)14.7(p)-365(la)18.4(bo)15.5(ra)19.2(to)13.2(ry)-355.9(me)17.7(nt)18.8(io)18.9(ne)15.1(d)]TJ 0 -1.0528 TD [(ab)15.1(ov)15.5(e.)-445.4(Af)15.7(te)18.4(rw)15.7(ar)13.5(ds)20(,)-455.6(t)0(h)13.2(e)-456.4(re)19.2(co)15.1(rd)19.6(ed)-451.5(da)20.8(ta)-453.9(we)16.9(re)-447.4(do)15.5(wn)17.3(lo)18.8(ad)15.1(ed)]TJ 0 -1.0471 TD [(us)14.4(in)18.8(g)-421.9(a)-422.3(co)15.1(mp)18.1(ut)18.9(er)70.4(.)-421.5(E)0(v)17.1(a)0(l)12.8(u)0(a)20.8(t)0(i)16.5(o)0(n)-411.3(o)0(f)-412.8(t)0(h)13.2(e)-422.3(re)19.2(co)15.1(rd)19.6(in)18.9(g)-421.9(w)0(a)16.9(s)-423.1(pe)15.1(r)20.4(-)]TJ 0 -1.0528 TD [(fo)13.9(rm)16.5(ed)-297.8(us)20(in)13.2(g)-308.1(t)13.9(he)-303.5(so)20(ft)17.3(wa)16.9(re)-299.4(pa)15.1(ck)20.8(ag)15.1(e)-308.5(o)0(f)-299(t)0(h)18.9(e)-308.5(sy)20(st)17.7(em)-301(\(M)17.7(es)13.9(a\))19.2(.)]TJ 0 -1.0471 TD [(Ad)17.3(di)13.2(ti)16.5(on)21.2(al)18.5(ly)75.8(,)-387.3(t)0(h)13.2(e)-388.1(re)13.5(co)20.8(rd)14(in)18.8(g)-393.4(w)0(a)16.9(s)-394.6(co)20.8(nv)15.5(er)19.2(te)18.4(d)-393.4(i)0(n)18.9(t)0(o)-385.2(a)-393.8(co)15.1(nt)18.9(in)18.8(-)]TJ 0 -1.0527 TD [(uo)15.5(us)-201.9(si)17.7(gn)21.2(al)18.5(.)-210.9(T)12.2(hi)13.2(s)-206.8(s)0(i)17.7(g)0(n)15.5(a)0(l)-197.8(w)0(a)16.9(s)-206.8(th)18.8(en)-201.1(in)18.8(te)12.8(gr)19.6(at)18.4(ed)-201.1(wi)14.9(th)-197.4(th)18.9(e)-211.7(d)0(i)18.8(g)0(i)18.9(t)0(a)18.5(l)]TJ T* [(po)15.5(ly)18.9(so)14.4(mn)18.1(og)21.2(ra)13.5(ph)21.2(y)-347.9(a)0(f)19.2(t)0(e)18.4(r)-349.5(ch)20.8(ec)14.7(ki)18.9(ng)-337.3(th)18.9(e)-342.6(p)0(r)13.9(o)0(p)21.2(e)0(r)-339.3(s)0(y)20(n)0(c)15.1(h)0(r)19.6(o)0(n)15.5(i)0(z)18.5(a)0(-)]TJ 0 -1.0471 TD [(ti)16.5(on)-314.5(of)-310.4(th)13.2(e)-319.8(c)0(l)18.4(o)0(c)15.1(k)0(s)20(.)-319.1(Th)17.1(is)-312.4(wa)11.2(s)-320.6(a)0(c)20.4(c)0(o)15.1(m)0(p)18.1(l)0(i)16.5(s)0(h)20(e)0(d)-314.9(b)0(y)-314.5(m)0(e)17.7(a)0(n)20.8(s)-326.3(of)-310.4(a)]TJ 0 -1.0528 TD [(sp)14.4(ec)20.4(ia)12.8(l)-310.4(c)0(o)15.1(m)0(p)18.1(u)0(t)18.9(e)0(r)-310.8(p)0(r)19.6(o)0(g)15.5(r)0(a)19.2(m)0(,)-305.9(w)0(h)17.3(i)0(c)12.8(h)-313.7(wa)16.9(s)-314.9(i)0(n)18.8(t)0(e)12.8(r)0(f)18(a)0(c)20.4(e)0(d)-309.2(w)0(i)14.9(t)0(h)-305.5(t)0(h)18.9(e)]TJ 0 -1.0471 TD [(mo)12.4(du)21.2(la)18.4(r)-423.5(d)0(a)20.8(t)0(a)-408.3(f)0(o)13.9(r)0(m)16.5(a)0(t)-408.3(o)0(f)-412.8(t)0(h)18.9(e)-416.6(di)13.2(gi)18.8(ta)18.5(l)-418.6(p)0(o)15.5(l)13.9(ys)14.3(om)18.1(no)15.5(gr)19.6(ap)15.1(hy)83.8(.)-415.8(A)]TJ 0 -1.0527 TD [(cr)13.5(os)20(s-)18.4(ch)15.1(ec)20.4(k)-507.2(w)0(a)16.9(s)-502.7(ca)14.7(rr)18(ie)18.4(d)-507.2(o)0(u)21.2(t)-509.6(on)-490.9(th)13.2(e)-501.9(b)0(a)15.1(s)0(i)17.7(s)-502.7(of)-498.2(t)13.9(h)0(e)-497(e)0(v)15.1(e)0(n)20.8(t)]TJ 0 -1.0471 TD [(ma)12(rk)19.6(in)18.8(g)-325.1(o)0(n)-314.5(b)0(o)15.5(t)0(h)-311.2(t)0(h)13.2(e)-319.8(po)15.5(ly)18.9(gr)13.9(ap)20.8(h)-325.1(a)0(n)20.8(d)-325.1(th)18.9(e)-325.5(p)0(H)-318.4(r)0(e)19.2(c)0(o)15.1(r)0(d)19.6(e)0(r)70.4(.)]TJ 1.0015 -1.0527 TD [(Bo)16.5(dy)-360(po)15.5(si)17.7(ti)16.5(on)-360(wa)16.9(s)-366.2(r)0(e)13.5(c)0(o)20.8(r)0(d)13.9(e)0(d)-360.4(b)0(y)-360(t)0(h)18.8(e)-371.1(ME)20.9(SA)-363.2(DL)-362.4(70)-360(re)19.2(-)]TJ -1.0015 -1.0471 TD [(co)15.1(rd)19.6(er)-379.1(an)20.8(d,)-371(in)-373.8(ad)15.1(di)18.9(ti)16.5(on)15.5(,)-381.7(w)12.4(as)-378.7(ve)20.8(ri)17.3(fi)17.3(ed)-377.5(by)-371.4(vi)18.9(de)15.1(o)-382(w)0(h)17.3(i)0(l)16.5(e)-382.4(th)18.9(e)]TJ 0 -1.0528 TD [(pa)15.1(ti)16.5(en)20.8(t)-327.5(w)0(a)16.9(s)-326.3(i)13.9(n)-325.1(th)18.8(e)-325.5(s)0(l)17.7(e)0(e)14.7(p)-325.1(la)18.4(bo)21.2(ra)13.5(to)18.8(ry)82.2(.)]TJ /F3 1 Tf 0 -2.3786 TD [(Dat)-8.6(a)-330.8(analys)-8.6(is)-335.2(and)-338(statistics)]TJ /F7 1 Tf 1.0015 -1.7527 TD [(Sl)14(ee)20.4(p)-365(s)0(t)17.7(a)0(g)15.1(e)0(s)-350.3(w)0(e)16.9(r)0(e)-356.3(e)0(v)15.1(a)0(l)18.4(u)0(a)20.8(t)0(e)12.8(d)-359.3(ac)14.7(co)20.8(rd)13.9(in)18.9(g)-359.3(t)0(o)-356.7(R)]TJ 6.974 0 0 6.974 494.362 300.813 Tm 0.0001 Tc [(EC)18.2(HT)21.5(SCH)25.8(A)0(F)18.2(-)]TJ -26.5344 -1.4958 TD [(FE)18(N)]TJ 9.963 0 0 9.963 324.624 290.381 Tm 0 Tc [(an)15.1(d)-234.1(K)]TJ 6.974 0 0 6.974 348.151 290.381 Tm 0.0001 Tc [(ALE)23.9(S)]TJ 9.963 0 0 9.963 367.597 290.381 Tm 0 Tc [([1)13.9(3])-230.7(and)-247.4(arousa)-8.2(ls)-244.1(were)-248.4(scored)-247.2(accordi)-10.5(ng)-240.5(to)]TJ -5.8499 -1.0528 TD [(Am)-8.6(erican)-408.1(Sleep)-410.2(Di)-7.8(sorders)-409.7(Associa)-9.1(tion)-411.8(\(ASDA\))-411.4(criteria)]TJ 0 -1.0471 TD [([14].)-376.5(Aro)-7.8(usals)-373.2(had)-378.3(to)-368.1(be)-377.5(characteri)-11.9(zed)-373(by)-371.4(alpha)-376.9(or)-373(beta)]TJ 0 -1.0527 TD [(wave)-7.8(s)-286.5(o)0(n)-291.7(the)-289.6(EEG)-293.3(for)]TJ /F10 1 Tf 9.213 0 TD ($)Tj /F7 1 Tf 0.8365 0 TD [(3)-285.3(s)-292.2(and)-287.2(not)]TJ /F6 1 Tf 4.7459 0 TD (>)Tj /F7 1 Tf 0.5577 0 TD [(15)-286.1(s,)-286.9(accom)-8.2(panied)]TJ -15.3531 -1.0471 TD [(by)-308.8(an)-309.2(increase)-314.5(in)-305.5(EMG)-308.2(acti)-8.6(vity)60.5(.)-307.7(A)-306.3(transition)-316.2(to)-305.5(wake)-7.8(ful-)]TJ 0 -1.0528 TD [(ness)-313.1(was)-309.4(scored)-315.5(if)-312.8(the)-306.7(freque)-8.6(ncy)-310(incre)-8.6(ase)-311.6(in)-305.5(EEG)-316.1(waves)]TJ T* [(persi)-9.4(sted)-462.3(for)]TJ /F6 1 Tf 5.5881 0 TD (>)Tj /F7 1 Tf 0.552 0 TD [(15)-462.5(s,)-463.3(and)-463.6(the)-460.3(corres)-9.8(pondin)-7(g)-461.7(epoch)-465.6(was)]TJ -6.1401 -1.0471 TD [(class)-9.4(ified)-238.2(as)-230.7(wake)-7.8(fulne)-8.2(ss.)-231.9(T)57.7(otal)-235.8(sleep)-235.8(time)-239(\(TST\))-236.4(was)-235.4(ca)-8(l-)]TJ 0 -1.0527 TD [(culat)-9.4(ed)-258(as)-253.5(well)-262.5(as)-253.5(wake)-7.8(fulness)-262.5(after)-260.6(sleep)-258.6(onset)-258.2(\(W)98.1(ASO\).)]TJ 1.0015 -1.0471 TD [(Ap)11.6(no)21.2(ea)14.7(s)-286.5(w)0(e)16.9(r)0(e)-282.4(s)0(c)19.6(o)0(r)13.9(e)0(d)-275.1(a)0(s)-282(a)-291.4(ce)20.4(ss)13.2(at)18.5(io)18.9(n)-291(o)0(f)-276.3(a)0(i)18.4(r)0(f)12.4(l)0(o)18.9(w)-289.2(fo)19.6(r)]TJ /F10 1 Tf 19.9852 0 TD ($)Tj /F7 1 Tf 0.8251 0 TD (10)Tj -21.8119 -1.0527 TD [(s.)-395(Hy)17.3(po)15.5(pn)21.2(oe)15.1(as)-390.1(we)11.2(re)-390.5(sc)13.9(or)19.6(ed)-394.6(as)-390.1(a)-405.2(r)0(e)19.2(d)0(u)15.5(c)0(t)18.4(i)0(o)18.9(n)-404.8(in)-390.9(ai)12.8(rf)18(lo)18.8(w)-403(t)0(o)]TJ 0 -1.0471 TD [(50)15.5(%)-321.8(a)0(n)15.1(d)-319.4(ox)15.5(yg)21.2(en)-314.9(de)20.8(sa)14(tu)18.9(ra)19.2(ti)16.5(on)-314.5(of)]TJ /F10 1 Tf 13.2704 0 TD ($)Tj /F7 1 Tf 0.8251 0 TD [(4%)13.2(.)-319.1(O)0(b)17.3(s)0(t)17.7(r)0(u)13.9(c)0(t)18.4(i)0(v)18.9(e)-319.9(sn)14.4(or)31(-)]TJ -14.0955 -1.0528 TD [(in)13.2(g)-518.6(w)0(a)16.9(s)-525.5(sc)19.6(or)13.9(ed)-514.1(if)-512(th)13.2(e)-519(m)0(i)15.7(c)0(r)13.5(o)0(p)21.2(h)0(o)15.5(n)0(e)-514.1(r)0(e)19.2(c)0(o)15.1(r)0(d)19.6(e)0(d)-514.1(n)0(o)15.5(i)0(s)17.7(e)-519(an)15.1(d)]TJ 0 -1.0471 TD [(ox)15.5(yg)15.5(en)-354.7(sa)19.6(tu)13.2(ra)19.2(ti)16.5(on)-354.3(dr)13.9(op)21.2(pe)15.1(d)-365(b)0(y)]TJ /F10 1 Tf 12.3713 0 TD ($)Tj /F7 1 Tf 0.8194 0 TD [(4%)13.2(.)-364.6(T)0(h)17.1(e)-365.4(ap)15.1(no)21.2(ea)14.7(/h)18.8(yp)15.5(op)21.2(-)]TJ -13.1907 -1.0528 TD 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[(du)15.5(ri)17.3(ng)-217.8(sl)17.7(ee)20.4(p.)-217.4(A)-232.3(s)0(i)17.7(g)0(n)21.2(i)0(f)17.3(i)0(c)18.4(a)0(n)15.1(t)-225.1(re)13.5(la)18.4(ti)16.5(on)-217.8(be)20.8(tw)14.9(ee)14.7(n)-228.4(t)13.9(he)-223.9(oc)20.8(cu)15.1(rr)18(en)20.8(ce)]TJ 0 -1.0471 TD [(of)-316.1(re)19.2(fl)17.3(ux)-314.5(ev)15.1(en)15.1(t)13.9(s)-326.3(an)15.1(d)-319.4(r)0(e)13.5(s)0(p)20(i)0(r)17.3(a)0(t)18.5(o)0(r)13.9(y)-325.1(ev)20.8(en)15.1(ts)-312.4(wa)16.9(s)-326.3(n)0(o)21.2(t)-327.5(se)19.6(en)15.1(.)]TJ 26.1993 16.0986 TD [(On)11.6(l)13.9(y)-359.3(fi)17.3(ve)-343.4(pa)15.1(ti)22.2(en)15.1(ts)-346.5(re)19.2(po)15.5(rt)17.3(ed)-343.4(sy)14.4(mp)18.1(to)18.9(ms)-347.3(of)-344.6(re)13.5(fl)17.3(ux)21.2(.)-353.2(H)0(o)17.3(w)0(-)]TJ -1.0015 -1.0698 TD [(ev)15.1(er)47.7(,)-381.6(r)0(e)19.2(f)0(l)17.3(u)0(x)-377.1(e)0(v)20.8(e)0(n)15.1(t)0(s)-375(d)0(u)21.2(r)0(i)17.3(n)0(g)-377.1(t)0(h)18.9(e)-382.4(da)15.1(y)-382(w)0(e)16.9(r)0(e)-373.4(f)0(o)13.9(u)0(n)21.2(d)-382(in)-379.5(al)18.4(l)-384.4(p)0(a)20.8(-)]TJ 0 -1.0755 TD [(ti)16.5(en)15.1(ts)17.7(,)-336.1(a)0(n)15.1(d)-336.5(se)13.9(ve)20.8(n)-342.2(p)0(a)20.8(t)0(i)16.5(e)0(n)15.1(t)0(s)-329.5(e)0(v)20.8(e)0(n)-332(e)0(x)15.1(h)0(i)18.9(b)0(i)18.9(t)0(e)18.4(d)-342.2(a)-336.9(p)0(a)15.1(t)0(h)18.9(o)0(l)18.9(o)0(g)15.5(i)0(c)18.5(a)0(l)18.4(l)0(y)]TJ 0 -1.0698 TD [(in)13.2(cr)19.2(ea)14.7(se)19.6(d)-273.9(p)0(e)15.1(r)0(c)19.2(e)0(n)15.1(t)13.9(ag)15.1(e)-274.3(o)0(f)-264.9(t)0(i)16.5(m)0(e)-266.8(w)0(i)14.9(t)0(h)-265.7(r)0(e)19.2(f)0(l)11.6(u)0(x)21.2(,)-273.5(ei)18.4(th)13.2(er)-265.3(du)21.2(ri)17.3(ng)-269(th)18.9(e)]TJ 0 -1.0755 TD [(da)15.1(y)-404.8(o)0(r)-401.5(n)0(i)18.9(g)0(h)21.2(t)0(.)-401.9(T)12.2(hi)18.9(s)-406(m)0(e)12(a)0(n)20.8(s)-406(th)13.2(at)-397(ga)20.8(st)17.7(ro)14(-o)19.6(es)19.6(op)15.5(ha)15.1(ge)20.8(al)-397(re)13.5(fl)17.3(ux)]TJ T* [(di)13.2(se)19.6(as)19.6(e)-479.2(i)0(n)-464.8(t)0(h)18.9(e)-479.2(pa)20.8(ti)16.5(en)15.1(ts)-466(in)-464.8(th)18.8(e)-479.2(p)0(r)19.6(e)0(s)19.6(e)0(n)15.1(t)-475.5(st)17.7(ud)15.5(y)-473.1(w)0(e)16.9(r)0(e)-470.2(m)0(o)18.1(r)0(e)]TJ 0 -1.0698 TD [(co)15.1(mm)14.9(on)-422.6(th)18.8(an)-423(in)-419.3(th)18.9(e)-433.7(g)0(e)20.8(n)0(e)15.1(r)0(a)19.2(l)-429.9(po)15.5(pu)21.2(la)12.8(ti)22.2(on)15.5(.)-432.9(T)12.2(he)-423(da)20.8(ta)-425.4(fr)18(om)]TJ 0 -1.0755 TD [(sl)17.7(ee)14.7(p)-330.8(a)0(p)20.8(n)0(o)15.5(e)0(a)-321(p)0(a)20.8(t)0(i)16.5(e)0(n)15.1(t)0(s)-318.1(a)0(l)12.8(s)0(o)-315.7(c)0(o)15.1(n)0(f)19.6(i)0(r)17.3(m)-334(th)18.9(e)-331.2(f)0(i)17.3(n)0(d)21.2(i)0(n)13.2(g)-325.1(th)13.2(at)-317.3(re)13.5(fl)17.3(ux)]TJ T* [(ev)15.1(en)15.1(t)13.9(s)-349.1(ar)19.2(e)-348.3(m)0(o)18.1(r)0(e)-339.3(c)0(o)15.1(m)0(m)14.9(o)0(n)-337.3(d)0(u)21.2(r)0(i)17.3(n)0(g)-343(t)13.9(he)-343.4(da)20.8(y)-347.9(t)0(h)18.9(a)0(n)-337.7(d)0(u)15.5(r)0(i)17.3(n)0(g)-337.3(t)0(h)18.9(e)]TJ 0 -1.0698 TD [(ni)13.2(gh)21.2(t)-276.3([)0(5)19.6(,)-273.5(10)21.2(,)-273.5(1)0(6)15.5(])0(.)-264.5(S)]TJ 6.974 0 0 6.974 383.754 485.631 Tm 0.0001 Tc [(CH)18.4(IN)15.8(DLE)23.9(BE)18.2(CK)]TJ /F3 1 Tf 9.963 0 0 9.963 434.778 485.631 Tm 0 Tc [(et)-266.1(al)18.9(.)]TJ /F7 1 Tf 2.2478 0 TD [([2)19.6(])-281.2(report)-10.6(ed)-280.8(that)-287.1(the)]TJ -14.841 -1.0755 TD [(like)-8.2(lihood)-390.6(of)-390.1(noctur)-9(nal)-392(reflux)-391.8(is)-392.1(eight)-390.2(times)-394.6(lower)-393.4(than)]TJ 0 -1.0698 TD [(that)-270(of)-270.6(daytime)-275.8(reflux.)-272.7(In)-264.9(the)-272.5(present)-273.1(study)60.9(,)-267.8(eight)-270.7(patie)-9.4(nts)]TJ 0 -1.0755 TD [(exh)-8.4(ibited)-325.1(noctur)-9(nal)-323.7(reflux,)-329.6(and,)-321.7(in)-322.6(five)-326.1(of)-321.8(these)-326.9(patien)-10.1(ts,)]TJ T* [(the)-278.2(percent)-10.5(age)-276.2(of)-270.6(time)-278.8(with)-279.2(a)-274.3(p)0(H)-272.9(o)0(f)]TJ /F6 1 Tf 14.5052 0 TD (<)Tj /F7 1 Tf 0.552 0 TD [(4)-273.9(was)-275.3(pathol)-9.7(ogical.)]TJ -15.0572 -1.0698 TD [(It)-227.4(was)-229.8(found)-227.3(that)-224.5(it)-228.2(was)-224.1(more)-230.1(like)-8.2(ly)-220.2(for)-227.4(noctur)-9(nal)-227(reflux)-226.8(to)]TJ 0 -1.0755 TD [(occ)-8.8(ur)-395.8(durin)-7.8(g)-393.4(W)100.5(ASO)-402(than)-398.5(durin)-7.8(g)-393.4(sleep)-8.2(.)-398.7(Neverthel)-12.7(ess,)-398.1(a)]TJ ET 1 i 58.28 758.834 478.205 -0.51 re f 58.28 713.99 478.205 -0.51 re f 58.28 621.864 478.205 -0.51 re f BT /F2 1 Tf 8.966 0 0 8.966 58.28 772.667 Tm [(Table)-331.9(2.)-336.7(\261)-718.9(Evaluation)-389.8(of)-381(arousal)-389.2(and)-386.2(transitions)-386.4(to)-387.3(wakefulness)-390.4(with)-387.1(concomitant)-386.9(evaluation)-383.7(of)-387.3(respiratory)-390.1(events)-382.4(and)]TJ 0 -1.0559 TD [(gastro-oesophageal)-334.6(reflux)-333.3(\(GOR\))-335.5(events)-331.8(in)-336.5(all)-333.5(patients)-330.9(who)-334.1(had)-335.7(nocturnal)-333.9(reflux)-333.3(events)]TJ /F7 1 Tf 0 -1.7072 TD (Patient)Tj 0 -1.0559 TD (No.)Tj 3.9076 1.0559 TD [(T)28.6(ime)-337.6(in)]TJ 0.8599 -1.0559 TD (bed)Tj -0.0506 -2.1119 TD (min)Tj 3.2057 3.1678 TD [(T)66.6(otal)-337.6(sleep)]TJ 1.3152 -1.0559 TD (time)Tj 0.1012 -2.1119 TD (min)Tj 4.015 3.1678 TD [(Apnoeas)-329.3(+)]TJ -0.196 -1.0559 TD (hypopnoeas)Tj 2.1308 -2.1119 TD (n)Tj 3.4966 3.1678 TD (Arousals)Tj 1.5049 -3.1678 TD (n)Tj 3.465 3.1678 TD (Arousals)Tj -0.588 -1.0559 TD [(with)-334.8(SRBD)]TJ 2.0992 -2.1119 TD (n)Tj 3.4523 3.1678 TD [(T)28.6(ransitions)]TJ 0.607 -1.0559 TD [(to)-336.5(wake)]TJ 1.3531 -2.1119 TD (n)Tj 3.4523 3.1678 TD [(T)34.9(ransitions)]TJ 0.607 -1.0559 TD [(to)-336.5(wake)]TJ -0.7461 -1.0559 TD [(with)-334.8(SRBD)]TJ 2.0929 -1.0559 TD (n)Tj 3.9265 3.1678 TD (GOR)Tj -0.215 -1.0559 TD (events)Tj 1.0117 -2.1119 TD (n)Tj 3.5977 3.1678 TD (GOR)Tj -0.2466 -1.0559 TD (during)Tj -0.1138 -1.0559 TD [(W)102.4(ASO)]TJ -0.5754 -1.0559 TD [(%)-328.8(W)102.4(ASO)]TJ 6.1522 3.1678 TD (GOR)Tj -1.2899 -1.0559 TD [(during)-335.4(TST)]TJ 0.8852 -2.1119 TD [(%)-335.1(TST)]TJ -48.718 -2.0043 TD [(1)-3736.4(460)-3128.3(280)-4089.4(177)-3337(206)-3476.1(151)-4159(22)-4576.8(12)-3723.2(24)-3021.4(18.3)-3466.3(23.6)]TJ 0 -1.0559 TD [(4)-3736.4(410)-3128.3(346)-4588.9(92)-3337.5(155)-3476.1(126)-4159(29)-4576.8(20)-4222.7(9)-3021.9(19.6)-3965.9(2.6)]TJ 0 -1.0496 TD [(6)-3736.4(457)-3128.3(430)-4089.4(715)-3337(709)-3476.1(687)-4159(15)-4608.4(1)32.1(1)-4223.2(3)-3521.4(0.0)-3966.4(0.8)]TJ 0 -1.0559 TD [(7)-3736.4(457)-3128.3(363)-4588.9(55)-3337.5(181)-3476.1(147)-4159(22)-5076.3(5)-4223.2(4)-3521.4(2.4)-3966.4(0.3)]TJ T* [(8)-3736.4(440)-3128.3(407)-4588.9(74)-3337.5(269)-3476.1(167)-4159(29)-4576.8(13)-4222.7(3)-3021.9(36.9)-3965.9(5.7)]TJ T* [(9)-3736.4(430)-3128.3(366)-4089.4(120)-3337(176)-3476.1(124)-4159(29)-4576.8(16)-3754.8(1)32.1(1)-3021.9(61.8)-3965.9(4.4)]TJ -0.4995 -1.0559 TD [(12)-3735.8(327)-3128.3(301)-4089.4(243)-3337(354)-3476.1(337)-4159(27)-4576.8(24)-3754.8(1)32.1(1)-3021.9(34.5)-3965.9(6.6)]TJ T* [(13)-3735.8(450)-3128.3(398)-4089.4(328)-3337(192)-3507.7(1)32.1(1)0(6)-4159.5(1)0(2)-4576.8(1)0(0)-4222.7(4)-3521.4(7.4)-3966.4(1.0)]TJ T* [(Mean)-1705.4(429\21344)-1587.3(361\21352)-2131(226\213218)-1466.6(280\213185)-1435(232\213197)-1865(23.1\2136.7)-1871.3(13.8\2136.0)-1435(8.6\2137.1)-853.8(22.6\21320.9)-1674.8(5.6\2137.6)]TJ 0 -1.9475 TD [(SRBD:)-333.6(sleep-related)-343.9(breathing)-335.8(disorders;)-332.5(W)102.4(ASO:)-334.3(wakefulness)-337.8(after)-336.4(sleep)-335.7(onset;)-331.5(TST)40.2(:)-337(total)-333.2(sleep)-335.7(time.)]TJ ET 0 0 0 0 k /GS3 gs q 471.8637 0 0 270.6319 111.6733 135.5351 cm /Im3 Do Q 0 0 0 1 k q 471.8637 0 0 270.6319 111.6733 135.5351 cm /Im4 Do Q 0 0 0 0 k 0 0 0 0 K 0 J 0 j 0.485 w 3.864 M []0 d 103.264 192.482 8.851 -33.465 re B 101.566 165.08 63.171 -18.187 re B 162.676 164.837 38.557 -6.426 re B 197.839 166.414 54.562 -14.429 re B 263.314 173.325 13.701 -10.064 re B 263.435 194.18 11.882 -19.764 re B 258.221 164.473 59.534 -18.188 re B 315.209 164.231 47.53 -17.702 re B 358.374 168.717 62.322 -17.096 re B 416.816 168.111 82.328 -21.946 re B 495.507 169.93 27.16 -12.852 re B 518.148 186.784 6.911 -20.976 re B 523.516 183.146 39.285 -15.399 re B 517.818 213.216 17.096 -27.524 re B 532.246 208.245 23.886 -15.763 re B 518.755 240.74 12.489 -29.343 re B 515.635 225.22 7.76 -14.914 re B 529.699 235.162 19.521 -14.429 re B 571.288 208.851 1.091 -5.456 re B 518.755 272.022 18.309 -35.769 re B 533.701 258.927 30.191 -15.763 re B 518.755 292.998 18.309 -26.069 re B 528.366 284.875 24.25 -12.368 re B 518.149 324.159 21.901 -113.732 re B 532.973 311.671 20.006 -12.731 re B 519.416 364.051 16.611 -42.195 re B 518.535 352.653 14.55 -35.041 re B 534.792 337.376 51.41 -16.369 re B 534.792 365.263 10.549 -15.762 re B 519.042 389.513 14.052 -42.195 re B 517.696 397.273 6.79 -9.7 re B 528.729 388.301 18.066 -12.731 re B 455.98 400.911 64.02 -8.973 re B 407.843 398.728 53.592 -6.79 re B 366.619 402.123 42.922 -9.7 re B 328.91 401.396 35.162 -8.972 re B 269.012 402.972 61.959 -10.549 re B 215.299 399.941 54.805 -7.396 re B 162.434 400.062 55.047 -7.154 re B 114.419 402.366 49.47 -8.73 re B 102.9 403.336 12.489 -10.549 re B 105.446 392.787 7.154 -41.831 re B 108.478 351.926 4.123 -74.326 re B 108.963 277.721 3.031 -65.111 re B 104.09 212.852 8.003 -36.86 re B 108.114 173.082 13.944 -5.941 re B 351.826 240.133 4.122 -5.214 re B 354.736 239.527 4.971 -1.697 re B 359.829 245.59 24.614 -10.549 re B 353.887 233.586 5.82 -23.401 re B 351.583 221.34 29.827 -11.882 re B 0 0 0 1 K 111.946 161.889 m 518.948 161.889 l 518.739 161.835 m 518.739 159.531 l 437.115 161.889 m 437.115 159.464 l 356.154 161.901 m 356.154 159.597 l 275.093 161.889 m 275.093 159.586 l 193.547 161.889 m 193.547 159.586 l 112.177 161.889 m 112.177 159.586 l S BT /F15 1 Tf 9.7 0 0 9.7 109.818 150.371 Tm 0 0 0 1 k /GS4 gs -0.0071 Tc [(0)-7626.1(0.5)-7607.6(1)]TJ 24.7809 0.0012 TD 0 Tc (1.5)Tj 8.7111 -0.0137 TD (2)Tj 8.1115 0.0068 TD -0.0134 Tc (2.5)Tj -22.1149 -1.2535 TD 0 Tc [(T)18(ime min)]TJ -24.5192 6.0966 TD (Snoring)Tj 1.375 5.325 TD (Abd)Tj 0.0875 2.5875 TD (thor)Tj /F17 1 Tf 0.5875 2.725 TD (V)Tj /F15 1 Tf 4.85 0 0 4.85 86.212 300.478 Tm ( )Tj 9.7 0 0 9.7 87.318 300.478 Tm (')Tj -1.7485 2.7307 TD (EMG)Tj 0.075 2.5613 TD (EOG)Tj 0.0875 2.833 TD (EEG)Tj ET /GS3 gs 109.036 187.296 m 109.036 168.017 l 109.036 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[(ge)15.1(ne)20.8(ra)13.5(l)-418.6(p)0(o)21.2(p)0(u)15.5(l)0(a)18.4(t)0(i)16.5(o)0(n)21.2(.)-421.5(O)12.4(b)0(e)15.1(s)0(i)17.7(t)0(y)-407.9(i)0(s)-409.1(c)0(o)15.1(m)0(m)14.9(o)0(n)-411.2(i)13.9(n)-421.9(p)0(a)20.8(t)0(i)16.5(e)0(n)15.1(t)0(s)-409.1(w)0(i)14.9(t)0(h)]TJ T* [(re)19.2(fl)17.3(ux)-212.1(an)15.1(d)-222.7(i)0(n)-208.8(p)0(a)15.1(t)0(i)16.5(e)0(n)20.8(t)0(s)-215.6(w)0(i)14.9(t)13.9(h)-222.7(o)0(b)15.5(s)0(t)17.7(r)0(u)19.6(c)0(t)18.5(i)0(v)13.2(e)-217.4(sl)17.7(ee)14.7(p)-222.7(a)0(p)20.8(n)0(o)15.5(e)0(a)20.4(.)-222.3(It)-210.4(ma)12(y)]TJ T* [(be)-309.2(hy)15.5(po)21.2(th)13.2(es)19.6(iz)18.4(ed)-314.9(th)18.9(at)-311.6(ob)21.2(es)13.9(it)16.5(y)-319.4(i)0(s)-306.7(a)-325.5(ve)20.8(ry)-310.4(im)15.7(po)15.5(rt)17.3(an)20.8(t)-321.8(f)0(a)19.2(c)0(t)12.8(o)0(r)-310.4(i)0(n)]TJ 0 -1.0641 TD [(th)18.9(e)-467.8(d)0(e)20.8(v)0(e)15.1(l)0(o)18.9(p)0(m)18.1(e)0(n)15.1(t)-464.1(of)-452.7(re)13.5(fl)17.3(ux)21.2(.)-467(T)74.8(o)-467.4(p)0(r)19.6(o)0(v)15.5(e)-462.1(th)18.9(is)-454.7(hy)15.5(po)15.5(th)18.9(es)19.6(is)17.7(,)-467(a)]TJ 0 -1.0698 TD [(la)18.4(r)20.4(g)0(e)15.1(r)-212.9(st)17.7(ud)21.2(y)-211.3(c)0(o)15.1(m)0(p)18.1(a)0(r)19.2(i)0(n)13.2(g)-211.3(pa)20.8(ti)16.5(en)20.8(ts)-204.3(wi)14.9(th)-203.1(an)20.8(d)-211.3(w)0(i)14.9(t)0(h)18.9(o)0(u)15.5(t)-208(ob)15.5(es)19.6(it)16.5(y)-211.3(i)0(s)]TJ T* [(re)19.2(qu)15.5(ir)17.3(ed)15.1(.)-256.5(T)12.2(he)-252.3(pr)19.6(es)19.6(en)15.1(t)-259.2(d)0(a)20.8(t)0(a)-249(i)0(n)13.2(d)0(i)18.9(c)0(a)20.4(t)0(e)-254.7(t)13.9(ha)15.1(t)-259.2(o)0(b)21.2(e)0(s)13.9(i)0(t)16.5(y)-256.8(mo)18.1(st)-249.8(pr)19.6(ob)15.5(-)]TJ T* [(ab)15.1(ly)-214.5(pr)19.6(om)12.4(ot)18.9(es)-219.4(or)-213.7(ag)15.1(gr)19.6(av)15.1(at)18.5(es)-219.4(a)-223.1(w)0(e)16.9(a)0(k)15.1(n)0(e)20.8(s)0(s)-220.2(o)0(f)-213.7(t)0(h)13.2(e)-223.1(lo)18.9(we)11.2(r)-224.3(o)0(e)20.8(s)0(o)14.4(-)]TJ 0 -1.0641 TD [(ph)15.5(ag)20.8(ea)14.7(l)-464.1(s)0(p)20(h)0(i)18.9(n)0(c)15.1(t)0(e)18.4(r)60.2(.)-461.3(I)0(n)-452.7(t)0(h)13.2(e)0(s)19.6(e)-462.1(ca)14.7(se)19.6(s,)-457.6(ne)20.8(ga)15.1(ti)16.5(ve)-451.5(in)18.9(tr)17.3(at)18.4(ho)15.5(ra)19.2(ci)12.8(c)]TJ 0 -1.0698 TD [(pr)19.6(es)13.9(su)20(re)-327.9(du)21.2(e)-336.9(t)0(o)-322.6(t)0(h)18.9(e)-336.9(co)20.8(nc)15.1(om)18.1(it)16.5(an)20.8(t)-333.2(o)0(b)15.5(s)0(t)17.7(r)0(u)19.6(c)0(t)12.8(i)0(v)18.9(e)-331.2(sl)17.7(ee)14.7(p)-330.8(a)0(p)15.1(n)0(o)21.2(e)0(a)]TJ T* [(fa)19.2(vo)15.5(ur)19.6(s)-292.2(t)0(h)18.9(e)-291.4(oc)20.8(cu)15.1(rr)18(en)15.1(ce)-275.5(of)-282(re)13.5(fl)17.3(ux)21.2(,)-290.6(b)0(u)21.2(t)-293.4(is)-278.2(no)15.5(t)-287.7(i)0(t)16.5(s)-286.5(ca)14.7(us)20(e.)-280.4(Th)17.1(is)]TJ T* [(ca)14.7(n)-421.9(b)0(e)-411.7(p)0(r)19.6(e)0(v)15.1(e)0(n)15.1(t)0(e)18.4(d)-421.9(by)-411.2(ef)24.9(fe)19.2(ct)18.4(iv)13.2(e)-422.3(t)0(r)17.3(e)0(a)20.4(t)0(m)15.7(e)0(n)15.1(t)-424.2(of)-412.8(sl)17.7(ee)20.4(p-)14(re)19.2(la)18.4(te)12.8(d)]TJ T* [(br)19.6(ea)14.7(th)18.9(in)18.9(g)-245.5(d)0(i)18.9(s)0(o)20(r)0(d)19.6(e)0(r)13.5(s)-241(an)20.8(d)-245.5(w)12.4(ou)15.5(ld)-231.5(ex)20.8(pl)13.2(ai)18.4(n)-239.8(t)0(h)18.9(e)-240.2(be)15.1(ne)15.1(fi)17.3(ci)18.4(al)-231.9(ef)30.6(fe)13.5(ct)]TJ 0 -1.0641 TD [(of)-225.1(na)15.1(sa)19.6(l)-236.5(c)0(o)20.8(n)0(t)13.2(i)0(n)18.9(u)0(o)21.2(u)0(s)-230.3(p)0(o)21.2(s)0(i)17.7(t)0(i)16.5(v)0(e)-223.9(a)0(i)12.8(r)0(w)15.7(a)0(y)-223.9(p)0(r)19.6(e)0(s)13.9(s)0(u)20(r)0(e)-225.5(v)0(e)15.1(n)0(t)18.9(i)0(l)16.5(a)0(t)18.4(i)0(o)18.9(n)-234.1(on)]TJ 0 -1.0698 TD [(ga)15.1(st)17.7(ro)19.6(-o)19.6(es)13.9(op)21.2(ha)15.1(ge)20.8(al)-345.7(re)13.5(fl)17.3(ux)-343(in)-345.3(pa)20.8(ti)16.5(en)15.1(ts)-346.5(su)20(f)20.4(f)0(e)13.5(r)0(i)17.3(n)0(g)-343(f)0(r)18(o)0(m)-346.1(b)0(o)15.5(t)0(h)]TJ T* [(di)18.9(so)14.4(rd)19.6(er)19.2(s)-326.3([)0(9)19.6(,)-324.7(18)15.5(,)-319.1(1)0(9)15.5(])0(.)]TJ /F5 1 Tf 8.966 0 0 8.966 402.349 771.647 Tm [(Refer)11.6(ences)]TJ /F7 1 Tf -10.3759 -2.1877 TD [(1.)-1766.5(Evans)-261.1(DF)75(.)-262.2(T)66.6(wenty-four)-262.5(hour)-258.2(ambulatory)-267.6(oesophageal)-256.3(pH)]TJ 2.5165 -1.1065 TD [(monitoring:)-335.5(an)-333.9(update.)]TJ /F3 1 Tf 9.5097 0 TD [(Br)-332.5(J)-334.4(Sur)31.9(g)]TJ /F7 1 Tf 4.2743 0 TD [(1987;)-335(74:)-336(157\261161.)]TJ -16.3005 -1.0749 TD [(2.)-1766.5(Schindlebeck)-438.9(NE,)-432.3(Heinrich)-440.8(C,)-430.8(Ko)]TJ 16.3574 0 TD [(\310)-82.7(nig)-437.1(A,)-435.6(Dendorfer)-437.4(A,)]TJ -13.8409 -1.1065 TD [(Page)-388.1(F)71.5(,)-388.6(Mu)]TJ 4.4134 -0.019 TD (\310)Tj 0.4047 0.019 TD [(ller-)8.7(Lissner)-391.1(SA.)-389.5(Optimal)-394.2(thresholds,)-391.4(sensiti-)]TJ -4.8181 -1.1065 TD [(vity)-249.3(and)-244.9(specifity)-257.2(of)-246.6(long)-247(term)-249.6(pH-metry)-251.8(for)-253.3(the)-247.2(detection)]TJ 0 -1.1002 TD [(of)-670.2(gastrooesophageal)-668.5(reflux)-671.3(disease.)]TJ /F3 1 Tf 16.2688 0 TD [(Gatr)26.8(oenter)31.5(ology)]TJ /F7 1 Tf -16.2688 -1.1065 TD [(1987;)-334.9(93:)-329.6(85\26190.)]TJ -2.5165 -1.0812 TD [(3.)-1766.5(W)32.8(ienbeck)-130.9(M,)-123.2(Barnert)-131.5(J.)-130.1(Epidemiology)-126.3(of)-126.4(reflux)-127.5(disease)-133.3(and)]TJ 2.5165 -1.1002 TD [(reflux)-336.2(oesophagitis.)]TJ /F3 1 Tf 8.2261 0 TD [(Scand)-332.3(J)-334.4(Gastr)26.1(oent)]TJ /F7 1 Tf 7.8088 0 TD [(1989;)-334.9(24:)-336(7\26113.)]TJ -18.5514 -1.0812 TD [(4.)-1766.5(Y)92(oung)-535.4(T)72.9(,)-540.4(Palta)-537.8(M,)-540.5(Dempsey)-539.8(J,)-541(Skatrud)-535.6(J,)-541(W)70.8(eber)-535.9(S,)]TJ 2.5165 -1.1002 TD [(Safwan)-328.1(B.)-329.6(The)-330.5(occurrence)-330.8(of)-328.7(sleep-disordered)-336.1(breathing)]TJ 0 -1.1065 TD [(among)-473.3(middle-aged)-475.5(adults.)]TJ /F3 1 Tf 11.6847 0 TD [(N)-472.1(Engl)-471.7(J)-467.2(Med)]TJ /F7 1 Tf 6.6201 0 TD [(1993;)-474(328:)]TJ -18.3048 -1.1065 TD (1230\2611235.)Tj -2.5165 -1.0749 TD [(5.)-1766.5(Demeester)-219.2(TR,)-218.7(Johnson)-213.8(LF)68.5(,)-211.6(Joseph)-220.4(GJ,)-215(T)60.2(oscano)-219(MS,)-216.1(Hall)]TJ 2.5165 -1.1065 TD [(A)73.1(W)83.4(,)-274.8(Skinner)-270(DB.)-275.5(Patterns)-279.2(of)-271.8(gastrooesophageal)-276.5(reflux)-272.9(in)]TJ T* [(health)-336.4(and)-333.4(disease.)]TJ /F3 1 Tf 7.9542 0 TD [(Ann)-337.1(Sur)31.9(g)]TJ /F7 1 Tf 4.1225 0 TD [(1976;)-334.9(184:)-335.5(459\261470.)]TJ -14.5933 -1.0749 TD [(6.)-1766.5(Freidin)-538(N,)-536.8(Fisher)-537.3(MJ,)-534.9(T)60.2(aylor)-538(W)83.4(,)-534(Boyd)-540.1(D,)-536.8(Surratt)-538.9(P)109.4(,)]TJ 2.5165 -1.1065 TD [(McCallum)-545(R)52.7(W)83.4(,)-546.7(Mittal)-544.4(RK.)-547.3(Sleep)-541.7(and)-548.4(nocturnal)-544.4(acid)]TJ T* [(reflux)-367.8(in)-368.1(normal)-368.7(subjects)-375.7(and)-365(patients)-370.5(with)-366.4(reflux)-374.1(oeso-)]TJ 0 -1.1002 TD (phagitis.)Tj /F3 1 Tf 3.7179 0 TD (Gut)Tj /F7 1 Tf 1.821 0 TD [(1991;)-334.9(32:)-329.6(1275\2611279.)]TJ -8.0554 -1.0812 TD [(7.)-1766.5(T)60.2(ardif)11.1(f)-424.1(C)0(,)-418.1(Pasquis)-423.2(P)103.1(,)-420.2(Samson-Dollfus)-422.8(D,)-423(Denis)-421.4(P)103.1(,)-420.2(V)104.7(er-)]TJ 2.5165 -1.1065 TD [(dure-Poussin)-390.9(A.)-385.1(Reflux)-390.5(Gastro-oesophagien)-394.3(et)-386.8(sommeil)]TJ 0 -1.1002 TD [(de)-314.9(nuit)-318.9(chez)-319.8(l)]TJ /F8 1 Tf 5.5136 0 TD (')Tj /F7 1 Tf 0.2213 0 TD [(adulte:)-319.3(methode)-322.7(et)-317.3(resultants)-321.1(obtenus)-315.9(chez)]TJ -5.7349 -1.1065 TD [(les)-355.9(sujects)-357.2(sains.)]TJ /F3 1 Tf 7.069 0 TD [(Rev)-355.6(EEG)-356.5(Neur)28(ophysiol)-355.7(Clin)]TJ /F7 1 Tf 11.8555 0 TD [(1986;)-353.9(16:)]TJ -18.9245 -1.1065 TD (49\26154.)Tj -2.5165 -1.0749 TD [(8.)-1766.5(Orr)-326.2(WC,)-322(Robinson)-326.7(MG,)-322(Johnson)-321.3(LF)68.5(.)-319.1(Acid)-325.9(clearing)-323.4(dur-)]TJ 2.5165 -1.1065 TD [(ing)-323.3(sleep)-329.4(in)-323.8(patients)-326.3(with)-328.5(oesophagitis)-325.4(and)-327(controls.)]TJ /F3 1 Tf 21.3335 0 TD (Dig)Tj -21.3335 -1.1065 TD [(Dis)-334.1(Sci)]TJ /F7 1 Tf 3.25 0 TD [(1981;)-328.6(26:)-336(423.)]TJ -5.7665 -1.0749 TD [(9.)-1766.5(Kerr)-236.9(P)109.4(,)-236.9(Shoenut)-231.1(JP)102.4(,)-230.5(Millar)-239.5(T)72.9(,)-230.5(Buckle)-231.2(P)103.1(,)-236.9(Kryger)-229.6(MH.)-233.5(Nasal)]TJ 2.5165 -1.1065 TD [(CP)86.2(AP)-279.1(reduces)-269.8(gastroesophageal)-277(reflux)-279.2(in)-273.3(obstructive)-275.1(sle-)]TJ 0 -1.1002 TD [(ep)-333.9(apnoea)-331.4(syndrom.)]TJ /F3 1 Tf 8.479 0 TD (Chest)Tj /F7 1 Tf 2.5924 0 TD [(1992;)-328.6(101:)-335.5(1539\2611544.)]TJ -13.5879 -1.0812 TD [(10.)-1266.5(Rasche)-305.7(K,)-309.2(Sanner)-305.9(B,)-310.6(Scha)]TJ 12.7912 0 TD [(\310)-57.4(fer)-310(T)72.9(,)-306.4(May)-302.4(B.)-310.6(Schlaf,)-311.1(Atmung)]TJ -10.2747 -1.1065 TD [(und)-308.3(gastroo)]TJ 4.3185 0 TD [(\310)-82.7(sophagealer)-314.2(Reflux.)]TJ /F3 1 Tf 8.7003 0 TD [(Dtsch)-313.9(Med)-308.5(Wschr)]TJ /F7 1 Tf 7.5306 0 TD (1997;)Tj -20.5495 -1.1002 TD [(122:)-335.5(659\261663.)]TJ -2.5165 -1.0812 TD [(1)25.8(1)0(.)-1292.3(Penzel)-256.5(T)72.9(,)-249.5(Amend)-255.3(G,)-252.3(Meinzer)-259(K,)-252.3(Peter)-258.2(JH,)-253(von)-251.4(W)26.5(ichert)-255.1(P)103.1(.)]TJ 2.5165 -1.1065 TD 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