Journal Article

Swallowing and breathing patterns during sleep in patients with obstructive sleep apnea

Fleetham, John A., Yagi, Kazutomo, Almeida, Fernanda R., Ayas, Najib T., Lowe, Alan A.

2015

Overview

Purpose The aims of this study were to determine the frequencies of swallowing and swallowing associated with arousals during sleep in patients with obstructive sleep apnea (OSA) and to determine whether these were associated with the severity of OSA and differed according to the preceding breathing route. Methods Standard audio-video polysomnography including an evaluation of swallowing-related elevation of the thyroid cartilage and breathing route (i.e., nasal or oronasal) was undertaken in an academic sleep laboratory. Fifty-six patients were analyzed (13 non-OSA patients, 17 mild, 10 moderate, and 16 severe OSA). Results The frequency of swallowing per hour of sleep was significantly higher in the severe OSA patients when compared to mild OSA patients (mild OSA, 3.1/h and severe OSA, 8.4/h). This was mainly due to the significantly higher frequency of swallowing associated with a respiratory event-related arousal in the severe OSA patients when compared to non- and mild OSA patients (non-OSA, 0.6/h; mild OSA, 1.0/h; severe OSA, 6.0/h), especially when swallowing was preceded by oronasal breathing (non-OSA, 0.2/h; mild OSA, 0.4/h; severe OSA, 4.2/h). Conclusions Swallowing frequency during sleep can increase with increasing OSA severity in most OSA patients. These events are predominately associated with respiratory event-related arousals and are more frequent when preceded by oronasal breathing. The observed swallowing under high ventilatory needs may compromise the maintenance of the pharynx as a conduit for airflow in OSA patients.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Adult / Air flow / Arousal / Arousal - physiology / Circadian rhythm / Deglutition - physiology / Dentistry / Female / Follow-Up Studies / Humans / Internal Medicine / Male / Medicine / Medicine & Public Health / Middle Aged / Neurology / Obstructive sleep apnea / Original Article / Otorhinolaryngology / Patients / Pediatrics / Pharyngeal structures / Pharynx - physiopathology / Pneumology/Respiratory System / Polysomnography / Prospective Studies / Random Allocation / Respiration / Severity / Sleep / Sleep apnea / Sleep Apnea, Obstructive - classification / Sleep Apnea, Obstructive - diagnosis / Sleep Apnea, Obstructive - physiopathology / Statistics as Topic / Swallowing