The pattern of swallowing during sleep

Lichter, Ivan; Muir, Roy

doi:10.1016/0013-4694(75)90267-9

Cited by 138 publications

(48 citation statements)

References 7 publications

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“…Nocturnal periods ofinfrequent or absent swallowing have often been assumed to be associated with sleep (27). In one study of normal subjects using EEG to monitor sleep, the author established that stable sleep was associated with a low incidence ofprimary peristalsis (26). The present study confirms that swallowing occurs infrequently during sleep.…”

supporting

confidence: 77%

“…The occurrence of volleys of swallows between sleep periods has also been noted previously in association with brief arousals from sleep or more prolonged periods of wakefulness (26). Such clusters of swallows do not appear to be caused by the presence of a recording assembly in the pharynx because earlier studies have monitored swallowing by techniques not requiring intubation (26,27). The reason for the relatively high frequency of spontaneous, nonperistaltic esophageal contractions during REM sleep is not clear.…”

mentioning

confidence: 68%

“…Additionally, we observed small drops of esophageal pH, generally associated with common cavity phenomena, that probably represented reflux of either small amounts of acid, gastric juice with a pH >4, or gas. Our finding that [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] 31-60 61-120 Time Esophageal pH < 4.0 multiple episodes of GE reflux occur in recumbent, asymptomatic subjects with normal esophageal function serves to reinforce the findings of other workers (12)(13)(14)(15). An important consideration is that the presence of the sleeve sensor across the LES may have prompted GE reflux in our volunteer subjects.…”

mentioning

confidence: 99%

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Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects.

Dent¹,

Dodds²,

Friedman³

et al. 1980

J. Clin. Invest.

860

479

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A B S T R A C T We investigated the mechanism of gastroesophageal reflux (GER) in 10 healthy volunteer subjects. Continuous recordings of intraluminal esophageal pH and pressure were obtained on two consecutive nights from 6:00 p.m. to 6:30 a.m. in each subject. During each study, the subject remained recumbent, except to eat a standardized meal after 1 h of basal recording. A manometric assembly with seven recording lumens monitored: (a) lower esophageal sphincter (LES) pressure via a sleeve device 6.5 cm in length, (b) esophageal-body motor activity, (c) swallowing activity in the pharynx, and (d) gastric pressure. An electrode 5 cm above the LES recorded esophageal pH. Sleep was monitored by electroencephalogram. All subjects showed wide variations ofbasal LES pressure. GER was not related to low steady-state basal LES pressure, but rather occurred during transient 5-30 s episodes of inappropriate complete LES relaxation. The inappropriate LES relaxations were usually either spontaneous or immediately followed appropriate sphincter relaxation induced by swallowing. The majority of GER episodes occurred within the first 3 h after eating. During the night LES relaxation and GER occurred only during transient arousals from sleep or when the subjects were fully awake, but not during stable sleep. After GER the esophagus was generally cleared of refluxed acid by primary peristalsis and less frequently by secondary peristalsis. Nonperistaltic contractions were less effective than peristalsis for clearing acid from the esophagus. We conclude that in asympto-A preliminary communication of this work was abstracted in 1978 (Gastroenterology. 74: 1119.) and was presented at the

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supporting

confidence: 77%

mentioning

confidence: 68%

mentioning

confidence: 99%

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Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects.

Dent¹,

Dodds²,

Friedman³

et al. 1980

J. Clin. Invest.

860

479

View full text Add to dashboard Cite

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“…Salivary flow rate is also very low during sleep compared with daytime activity, although the rate in different sleep states is not known (Gemba et al, 1996). Compared with the awake state, swallowing is also lower in sleep, and is lower in deep non-REM or REM sleep stages than in non-REM light sleep (Lichter and Muir, 1975;Castiglione et al, 1993). We have recently proposed that, during sleep, RMMA could contribute to triggering the release of saliva to protect, through a lubricating action, the integrity and health of the upper alimentary tract (e.g., oro-esophageal structures) (Thie et al, 2002).…”

Section: Salivation and Sleepmentioning

confidence: 99%

NeurobiologicalMechanismsInvolved inSleepBruxism

Lavigne

Kato

Kolta

et al. 2003

Critical Reviews in Oral Biology & Medicine

441

290

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Sleep bruxism (SB) is reported by 8% of the adult population and is mainly associated with rhythmic masticatory muscle activity (RMMA) characterized by repetitive jaw muscle contractions (3 bursts or more at a frequency of 1 Hz). The consequences of SB may include tooth destruction, jaw pain, headaches, or the limitation of mandibular movement, as well as tooth-grinding sounds that disrupt the sleep of bed partners. SB is probably an extreme manifestation of a masticatory muscle activity occurring during the sleep of most normal subjects, since RMMA is observed in 60% of normal sleepers in the absence of grinding sounds. The pathophysiology of SB is becoming clearer, and there is an abundance of evidence outlining the neurophysiology and neurochemistry of rhythmic jaw movements (RJM) in relation to chewing, swallowing, and breathing. The sleep literature provides much evidence describing the mechanisms involved in the reduction of muscle tone, from sleep onset to the atonia that characterizes rapid eye movement (REM) sleep. Several brainstem structures (e.g., reticular pontis oralis, pontis caudalis, parvocellularis) and neurochemicals (e.g., serotonin, dopamine, gamma aminobutyric acid [GABA], noradrenaline) are involved in both the genesis of RJM and the modulation of muscle tone during sleep. It remains unknown why a high percentage of normal subjects present RMMA during sleep and why this activity is three times more frequent and higher in amplitude in SB patients. It is also unclear why RMMA during sleep is characterized by co-activation of both jaw-opening and jawclosing muscles instead of the alternating jaw-opening and jaw-closing muscle activity pattern typical of chewing. The final section of this review proposes that RMMA during sleep has a role in lubricating the upper alimentary tract and increasing airway patency. The review concludes with an outline of questions for future research.

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“…The high ~atural rate of swaltowing leads to about 1000 swallows daily or 3-4 million swallows per ~leeade. During sleep, salivation and swallows virtually cease [5]. Clusters of swallows occur during arOUsals from sleep, but swallows seldom occur ~tUring physiological sleep [2].…”

Section: Introductionmentioning

confidence: 99%