Assessment of Change in Palatal Sensation in Obstructive Sleep Apnea Patients by Using Two-Point Palatal Discrimination

Abstract

Objectives.Patients with obstructive sleep apnea syndrome (OSAS) have impaired responses to inspiratory resistive loading during sleep. This may be due, in part, to a change in the upper airway sensation. Therefore, we hypothesized that patients with OSAS have diminished upper airway sensation due to snoring.Methods.A total of 53 participants were selected based on clinical evaluation and polysomnography. Two-point discrimination was measured with modified calipers in the tongue and soft palate.Results.A total of 10 participants were included in the control group, 12 participants in the simple snoring group, and 27 participants in the OSAS group. There were 12 patients in the impaired sensation group of the OSAS group. On comparing polysomnography, patients with impairment of their palatal sensory input in two-point discrimination (TPD) had a more protracted duration of the longest snoring episode than those with simple snoring and normal sensation. Patients with decreased sensory input in TPD had longer average duration of snoring episodes and relative snoring time than those with simple snoring and normal sensory input in cold uvular TPD. Comparison of the cold uvular TPD for normal sensation and impaired sensation in patients with OSAS after treatment showed a different trend.Conclusion.Impaired sensation of the soft palate was correlated with the longest snoring episode duration, average snoring episode duration, and relative snoring time. It is helpful in detecting the early stage of neural degradation in OSAS patients by assessing snoring components of polysomnography and TPD in the soft palate.

Investigation of smell and taste function in patients with obstructive sleep apnoea syndrome

“…They reported a two-point discrimination threshold of 2.5 mm for the early diagnosis of probable soft palate peripheral neuropathy in OSAS patients. 26 We consider that the drying effect of mouth breathing may mean that odours do not dissolve in the saliva and mucus, and this may be another reason for taste disturbance.…”

A retrospective study: does upper airway morphology differ between non-positional and positional obstructive sleep apnea?

“…Historically, the soft palate was larger in OSAHS than non-OSAHS patients ( Lowe et al, 1996 ), and has been shown to play a key role in OSAHS ( Bacon et al, 1990 ). In addition, fatty infiltration (regardless of obesity status) ( Zohar et al, 1998 ) impairs soft palate sensation, which correlates with the severity of snoring ( Jeong et al, 2016 ); the soft palate becomes altered and exhibits a fiber-type appearance caused by the additional load on the velopharyngeal muscles ( Lindman & Stal, 2002 ) in OSAHS patients. These factors may affect compliance of the soft palate and can cause narrowing of the upper airway.…”

Peer Review #1 of "A retrospective study: does upper airway morphology differ between non-positional and positional obstructive sleep apnea? (v0.1)"

“…Historically, the soft palate was larger in OSAHS than non-OSAHS patients (Lowe et al 1996), and has been shown to play a key role in OSAHS (Bacon et al 1990). In addition, fatty infiltration (regardless of obesity status) (Zohar et al 1998) impairs soft palate sensation, which correlates with the severity of snoring (Jeong et al 2016); the soft palate becomes altered and exhibits a fiber-type appearance caused by the additional load on the velopharyngeal muscles (Lindman & Stål 2002) in OSAHS patients. These factors may affect compliance of the soft palate and can cause narrowing of the upper airway.…”