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. 2022 Feb;42(1):82-88.
doi: 10.14639/0392-100X-N1578. Epub 2022 Feb 7.

The association between dysphagia and OSA

Lorenzo Marra  1 , Giada Cavallaro  2 , Valentina Di Lecce  3 , Giorgio Castellana  4 , Carla Santomasi  3 , Vincenzo Di Nicola  2 , Nicola Antonio Adolfo Quaranta  2 , Giovanna Elisiana Carpagnano  3 , Onofrio Resta  3 , Maria Luisa Fiorella  2
Affiliations

The association between dysphagia and OSA

Lorenzo Marra et al. Acta Otorhinolaryngol Ital. 2022 Feb.

Abstract
in English, Italian

Objective: The aim of our study was to investigate the presence of dysphagia in patients with Obstructive Sleep Apnoea (OSA) and to correlate swallowing impairment with hypnologic and anatomic parameters.

Methods: The study population includes 36 patients suffering from OSA. Patients were divided into two groups using the presence of dysphagia as a distinctive parameter. Group 1 included 27 OSA patients without signs of dysphagia and Group 2 included 9 OSA patients with signs of dysphagia.

Results: The age of patients in Group 2 was higher compared with the age of patients in Group 1. Analysis of Continuous Positive Airway Pressure (CPAP), obtained in the titration phase, showed that OSA patients with signs of dysphagia required a higher level of CPAP pressure than those who were not affected by swallowing abnormalities (12.6 ± 1 vs 10.5 ± 1.9 p = 0.003). No other differences in anthropometric, hypnologic, or arterial blood gas values were found between the two groups.

Conclusions: In clinical practice, all OSA patients should undergo a complete ENT exam, including assessment of swallowing, before CPAP therapy is started. This may predict the need for higher CPAP pressure settings to resolve apnoea episodes in the presence of dysphagia as well as guide the choice of CPAP interfaces (orofacial vs. nasal) in these patients.

Disfagia e OSA.

Obiettivo: Il nostro studio ha avuto come obiettivo la ricerca nei pazienti OSA di evidenze di disfagia e l’associazione della presenza di disfagia alla anatomia delle prime vie aero-digestive e ai parametri ipnologici ed emogasanalitici di questi pazienti.

Metodi: Tutti i pazienti sono stati sottoposti a emogasanalisi, spirometria, rinomanometria, videofibrorinolaringoscopia, valutazione fibroendoscopica della deglutizione (FEES), polisonnografia notturna, studio di titolazione della pressione di lavoro di CPAP, somministrazione del questionario “SWAL-QOL”.

Risultati: Il 25% della popolazione studiata ha presentato segni subclinici di disfagia. Il gruppo dei pazienti non disfagici era formato da soggetti più giovani rispetto al gruppo dei pazienti disfagici. Il distretto orofaringeo è risultato essere il sito di ostruzione più frequente per entrambi i gruppi. Nello studio di titolazione della pressione di lavoro di CPAP, i pazienti disfagici necessitano di valori di pressione più alti.

Conclusioni: Un paziente OSA su 4 ha presentato segni di disfagia. La disfagia è associata a valori più elevati di pressione allo studio di titolazione della CPAP. I pazienti OSA hanno un rischio più elevato di presentare disturbi di deglutizione con l’avanzare dell’età rispetto alla popolazione generale.

Keywords: CPAP; dysphagia; obstructive sleep apnoea syndrome; swallowing impairment.

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Figures

Figure 1.
Figure 1.
NOHL classification. N: Nose; O: oropharynx; H: hypopharynx; L: larynx; percentage of patients and grade of obstruction.
See this image and copyright information in PMC

References

    1. Strollo PJ, Jr, Rogers RM. Obstructive sleep apnea. N Engl J Med 1996;334:99-104. https://doi.org/10.1056/NEJM199601113340207 10.1056/NEJM199601113340207 - DOI - PubMed
    1. Peppard PE, Young T, Palta M, et al. . Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000;342:1378-1384. https://doi.org/10.1056/NEJM200005113421901 10.1056/NEJM200005113421901 - DOI - PubMed
    1. Lindberg E, Carter N, Gislason T, et al. . Role of snoring and daytime sleepiness in occupational accidents. Am J Respir Crit Care Med 2001;164:2031-2035. https://doi.org/10.1164/ajrccm.164.11.2102028 10.1164/ajrccm.164.11.2102028 - DOI - PubMed
    1. Berry RB, Budhiraja R, Gottlieb DJ, et al. . American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012;8:597-619. https://doi.org/10.5664/jcsm.2172 10.5664/jcsm.2172 - DOI - PMC - PubMed
    1. Ruehland WR, Rochford PD, O’Donoghue FJ, et al. . The new AASM criteria for scoring hypopneas: impact on the apnea hypopnea index. Sleep 2009;32:150-157. https://doi.org/10.1093/sleep/32.2.15 10.1093/sleep/32.2.15 - DOI - PMC - PubMed