Background
Epidemiology of dysphagia and its drivers in obstructive sleep apnea (OSA) are poorly understood. The study aims to investigate the prevalence of dysphagia symptoms and their association with demographic and clinical factors in patients with OSA.
Methods
Patients with OSA referring to an Academic Sleep Outpatient Clinic were enrolled in a prospective study. Demographic, clinical characteristics, and OSA symptoms were collected. All patients underwent home sleep cardiorespiratory polygraphy and the Eating-Assessment Tool questionnaire (EAT-10) to investigate dysphagia symptoms. Patients with a positive EAT-10 were offered to undergo a fiberoptic endoscopic evaluation of swallowing (FEES) to confirm the presence of dysphagia. FEES findings were compared with a healthy control group. Univariate and multivariate analyses were performed to assess predictors of dysphagia.
Results
951 patients with OSA (70% males, age 62 IQR51-71) completed the EAT-10, and 141 (15%) reported symptoms of dysphagia. Female gender (OR = 2.31), excessive daily sleepiness (OR = 2.24), number of OSA symptoms (OR = 1.25), anxiety/depression (OR = 1.89), and symptoms of gastroesophageal reflux (OR = 2.75) were significantly (p < 0.05) associated with dysphagia symptoms. Dysphagia was confirmed in 34 out of 35 symptomatic patients that accepted to undergo FEES. Patients with OSA exhibited lower bolus location at swallow onset, greater pharyngeal residue, and higher frequency and severity of penetration and aspiration events than healthy subjects (p < 0.05).
Conclusion
A consistent number of patients with OSA show symptoms of dysphagia, which are increased in females and patients with a greater OSA symptomatology, anxiety and depression, and gastroesophageal reflux. The EAT-10 appears a useful tool to guide the selection of patients at high risk of dysphagia. In clinical practice, the integration of screening for dysphagia in patients with OSA appears advisable.
Background: exhaled nitric oxide (eNO) is an endogenous gas involved in airway pathophysiology and is determined in orally exhaled air by various techniques. however, traditional single-breath technique (eNO sB ) requires active cooperation and is not always easily practicable (especially in young children); simpler techniques including tidal breathing measurements (eNO TB ) are not standardized. The aim of this study was to evaluate the possible correlation and correspondence between eNO sB and eNO TB and the impact of potential confounders in children with chronic adenotonsillar disease. Methods: eighty-six children (mean age 8.7 ± 3.2 y) underwent eNO assessment by means of eNO sB and eNO TB . The correlation among eNO TB , eNO sB , and other potential confounders (i.e., gender, age, weight, height, BMI, and passive smoking exposure) were studied. results: The analyses showed a poor correspondence between eNO sB and eNO TB , with the latter underestimating (P < 0.001) mean eNO values: 6.4 parts per billion (ppb) (95% confidence interval (cI): 8.4-11.4 ppb) vs. 9.8 ppb (95% cI: 5.6-7.3 ppb). a greater correlation was found between eNO sB and eNO TB in children younger than 6 y. Only eNO sB and age predicted eNO TB (R 2 = 43.6%). conclusion: eNO TB is not a good predictor of eNO sB in children. constant-flow eNO sB is the technique of choice for eNO assessment in young children.
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