Dysphagia in patients with moderate and severe obstructive sleep apnea

Campanholo, Milena de Almeida Torres; Caparroz, Fábio de Azevedo; Stefanini, Renato; Haddad, Leonardo; Bittencourt, Lia Rita Azeredo; Tufik, Sérgio; Haddad, Fernanda Louise Martinho

doi:10.1016/j.bjorl.2019.10.004

Cited by 9 publications

(5 citation statements)

References 20 publications

(23 reference statements)

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“…In a study of FEES in patients with symptomatic OSAS, 34 out of 35 patients had dysphagia 12 . Similarly, another study of FEES in OSAS patients demonstrated that 27.3% of patients had dysphagia 25 . However, despite the presence of objective swallowing abnormalities, OSAS patients did not voluntarily report symptoms of dysphagia 23,26 .…”

Section: Resultsmentioning

confidence: 80%

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Alterations in the Swallowing Function According to the Severity of Obstructive Sleep Apnea Syndrome

Mun

Song

Yang

et al. 2022

Journal of the Korean Dysphagia Society

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Objective: Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder that can have a significant impact on the quality of life. According to recent studies, some OSAS patients exhibit swallowing abnormalities, such as the premature entry of food into the hypopharynx, and laryngeal penetration. We aimed to evaluate the swallowing function of OSAS patients and compare swallowing-related parameters between OSAS severity groups through a video fluoroscopic swallowing study (VFSS). Methods: Ninety-two participants with a symptom of snoring were enrolled in this retrospective study. Eighty-four participants were diagnosed with OSAS by polysomnography. The subjects were evaluated using the apnea-hypopnea index (AHI) and divided into four groups, namely non-OSAS, mild, moderate, and severe OSAS. Since all patients reported choking symptoms, they underwent VFSS and were evaluated for penetration or aspiration. The temporal parameters evaluated were oral transit time, pharyngeal transit time, and pharyngeal delay time. The movement parameters assessed were the distance, duration, and velocity of laryngeal elevation (LE). Results: Penetration was detected in six OSAS patients, but aspiration was not observed in any patient. Seventy-four patients showed vallecular and pyriform sinus residue, although the amount was not significantly large. There was no significant difference in any of the temporal parameters between the groups except pharyngeal transit time with 10 ml of yogurt. In the Pearson's correlation and multivariate linear regression analysis, LE distance and LE velocity, both correlated with AHI scores with 5 ml of liquid, 10 ml of liquid, and 10 ml of yogurt, respectively. Conclusion: Severe OSAS patients showed longer and faster hyolaryngeal movement while swallowing, which may be a compensatory movement to prevent penetration or aspiration. (JKDS 2022;12:14-23

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Section: Resultsmentioning

confidence: 80%

“…Swallowing dysfunction does not appear to be serious in OSAS patients 25 . In a previous study, laryngeal penetration was observed in 5% of the OSAS patients, but subglottic aspiration was not observed 9 .…”

Section: Resultsmentioning

confidence: 94%

Alterations in the Swallowing Function According to the Severity of Obstructive Sleep Apnea Syndrome

Mun

Song

Yang

et al. 2022

Journal of the Korean Dysphagia Society

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“…These results are due to the evidence in the cited areas. 38,[56][57][58][59][60][61][62][63][64][65][66][67] In cases of SDB, the goal of SLH assessment is to determine muscle and functional imbalances that may affect UA permeability during sleep. 19 The eligibility for SLH therapy intervention alone is related to these patients' lack of impeditive factors, such as mechanical airway obstruction, craniofacial changes, neuromuscular diseases, and orofacial myofunctional disorders.…”

Section: Discussionmentioning

confidence: 99%

Brazilian Consensus on Sleep-Focused Speech-Language-Hearing Sciences - 2023 Brazilian Sleep Association

Studart-Pereira,

Bianchini,

Assis

et al. 2023

Sleep Sci

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Introduction This consensus aimed to develop a structured document presenting the role of sleep-focused Speech-Language-Hearing (SPH) Sciences (SPHS). The recommendations were based on the expertise of specialists and on evidence in the literature, aiming to guide the coverage of this area and the consequent improvement in the quality of the professionals' approach. Methods A Delphi method was conducted with 49 SLH pathologists (SLHP), four sleep physicians, one dentist, one physical therapist, and one methodologist. Four Delphi panel rounds were conducted in Google Forms. The items were analyzed based on the panelists' percentage of agreement; consensuses were reached when ⅔ (66.6%) of valid responses were on a same on a same answer (either “agree” or “disagree”). Results Participants voted on 102 items. The mean consensus rate was 89.9% ± 10.9%. The essential topics were the importance of professional training, the SLH diagnosis, and the SLH treatment of sleep disorders. It was verified that all fields of the SLHS are related to the area of sleep; that sleep-focused SLH pathologists (SLHP) are the responsible for assessing, indicating, and conducting specific orofacial myofunctional therapy for sleep-disordered breathing alone or in combination with other treatments; that SLHP are included in interdisciplinary teams in the area of sleep in public and private services. Discussion The Brazilian consensus on sleep-focused SLHS is a landmark in this area. This consensus described the scope of action of sleep-focused SLHP and systematized recommendations being useful as a reference for the professional practice in the area of sleep.

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“…OSA is characterized by frequent upper airway collapses that cause periodic episodes of apnea and hypopnea [4], which condition may be associated with oropharyngeal dysphagia [5]. Commonly underdiagnosed in this population, interference with swallowing dynamics is evidenced through instrumental swallowing tests, such as those based on videofluoroscopy and fiberoptic endoscopic evaluation of swallowing (FESS) [6][7][8][9][10][11]. The frequent episodes of apnea and hypopnea lead to oxyhemoglobin desaturation, which interferes with the proper synchrony between swallowing and breathing functions [12,13].…”

Section: Introductionmentioning

confidence: 99%

Swallowing outcome to speech therapy intervention in resistant hypertensive patients with obstructive sleep apnea

Borges

Muniz

Ferreira

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose To evaluate (i) the outcome of swallowing therapy program on the rehabilitation of oropharyngeal dysphagia in resistant hypertensive patients with obstructive sleep apnea (OSA) and (ii) the association between the clinical and anthropometric characteristics of these individuals and this outcome. Methods This was a prospective interventional study in which resistant hypertensives diagnosed with OSA by polysomnography and dysphagia by fiberoptic endoscopic evaluation of swallowing (FESS) participated. All participants underwent a FEES and assessment of the risk of dysphagia (Eating Assessment Tool, EAT-10) and swallowing-related quality of life (Swal–QoL) before and after the intervention. The therapeutic program was performed daily by the participants, with weekly speech-therapist supervision for eight weeks, including the following strategies: Masako, chin tuck against resistance, and expiratory muscle training. Results A total of 26 (78.8%) of the participants exhibited improvement in the degree of dysphagia in the intervention outcome. After the intervention, there was a statistically significant improvement in the level of penetration–aspiration ( p = 0.007), the degree of pharyngeal residue ( p = 0.001), the site of onset of the pharyngeal phase ( p = 0.001), and the severity of dysphagia ( p = 0.001) compared to before intervention. The EAT-10 score was 2 (0–6) before and 0 (0–3) after intervention ( p = 0.023). Swal–QoL had a score on the symptom frequency domain of 92.8 (75–100) before and 98.2 (87.5–100) after intervention ( p = 0.002). Conclusions Resistant hypertensive patients with OSA showed improved swallowing performance after swallowing therapy program. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-022-07612-3.

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Dysphagia in patients with moderate and severe obstructive sleep apnea

Cited by 9 publications

References 20 publications

Alterations in the Swallowing Function According to the Severity of Obstructive Sleep Apnea Syndrome

Alterations in the Swallowing Function According to the Severity of Obstructive Sleep Apnea Syndrome

Brazilian Consensus on Sleep-Focused Speech-Language-Hearing Sciences - 2023 Brazilian Sleep Association

Swallowing outcome to speech therapy intervention in resistant hypertensive patients with obstructive sleep apnea

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