Dysphagia symptoms in obstructive sleep apnea: prevalence and clinical correlates.

Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 101090633 Publication Model: Electronic Cited Medium: Internet ISSN: 1465-993X (Electronic) Linking ISSN: 14659921 NLM ISO Abbreviation: Respir Res Subsets: MEDLINE

Publication: 2001- : London : BioMed Central Ltd.
Original Publication: London : Current Science Ltd., c2000-

Deglutition*; Deglutition Disorders/*epidemiology ; Sleep Apnea, Obstructive/*epidemiology; Aged ; Case-Control Studies ; Deglutition Disorders/diagnosis ; Deglutition Disorders/physiopathology ; Female ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/physiopathology

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.

Laryngoscope. 1998 Mar;108(3):431-6. (PMID: 9504620)
Dysphagia. 2019 Apr;34(2):192-200. (PMID: 30456424)
CMAJ. 2014 Apr 1;186(6):415-21. (PMID: 24591276)
Arch Neurol. 2007 Jan;64(1):58-62. (PMID: 17210809)
Sleep Breath. 2020 Sep;24(3):791-799. (PMID: 32062752)
Ann Otol Rhinol Laryngol. 2013 May;122(5):335-8. (PMID: 23815051)
Dysphagia. 2014 Feb;29(1):44-51. (PMID: 23817806)
J Speech Lang Hear Res. 2008 Feb;51(1):S240-58. (PMID: 18230849)
Dysphagia. 2015 Apr;30(2):114-20. (PMID: 25432669)
Gastroenterol Res Pract. 2011;2011:. (PMID: 20811545)
Sleep Breath. 2011 May;15(2):209-13. (PMID: 21229321)
J Appl Physiol (1985). 2007 Apr;102(4):1587-94. (PMID: 17185498)
BMC Health Serv Res. 2018 Aug 2;18(1):594. (PMID: 30068326)
Dysphagia. 2002 Spring;17(2):139-46. (PMID: 11956839)
J Psychosom Res. 2017 Jun;97:102-110. (PMID: 28606489)
Sleep Breath. 2019 Jun;23(2):389-397. (PMID: 29987514)
Dysphagia. 1995 Fall;10(4):248-54. (PMID: 7493505)
Sleep Breath. 2019 Jun;23(2):619-626. (PMID: 31020485)
Otolaryngol Head Neck Surg. 2019 May;160(5):885-890. (PMID: 30665331)
Sleep Med Rev. 2008 Dec;12(6):481-96. (PMID: 18951050)
Dysphagia. 2001 Fall;16(4):249-53. (PMID: 11720400)
J Clin Endocrinol Metab. 2005 Aug;90(8):4510-5. (PMID: 15941867)
Cranio. 2016 Mar;34(2):95-9. (PMID: 26726009)
Dysphagia. 2016 Apr;31(2):214-22. (PMID: 26753926)
Eur Respir J. 2007 Jul;30(1):110-13. (PMID: 17360730)
Ann Otol Rhinol Laryngol. 2013 Nov;122(11):717-24. (PMID: 24358633)
Geriatrics (Basel). 2018 Oct 12;3(4):. (PMID: 31011104)
Laryngoscope. 2001 Aug;111(8):1313-7. (PMID: 11568561)
Am J Epidemiol. 2013 May 1;177(9):1006-14. (PMID: 23589584)
Ann Otol Rhinol Laryngol. 2009 Jan;118(1):30-6. (PMID: 19244961)
Laryngoscope. 1976 Oct;86(10):1531-9. (PMID: 966918)
Dysphagia. 2018 Apr;33(2):141-172. (PMID: 28866854)
Neurogastroenterol Motil. 2015 Feb;27(2):212-9. (PMID: 25376877)
J Oral Rehabil. 2018 Sep;45(9):692-701. (PMID: 29889982)
Ann Otol Rhinol Laryngol. 2008 Dec;117(12):919-24. (PMID: 19140539)
Dysphagia. 1996 Spring;11(2):93-8. (PMID: 8721066)
J Neurol Neurosurg Psychiatry. 1993 Apr;56(4):426-7. (PMID: 8482970)
Chest. 1999 Jul;116(1):17-21. (PMID: 10424498)
J Thorac Dis. 2019 May;11(Suppl 9):S1147-S1149. (PMID: 31245068)
Dysphagia. 2016 Dec;31(6):771-780. (PMID: 27515710)
J Voice. 2002 Jun;16(2):274-7. (PMID: 12150380)
Aliment Pharmacol Ther. 2013 Mar;37(5):564-72. (PMID: 23289763)
PLoS One. 2016 Apr 06;11(4):e0152749. (PMID: 27050437)
Sleep Breath. 2012 Jun;16(2):375-81. (PMID: 21465092)
Otolaryngol Clin North Am. 2013 Dec;46(6):965-87. (PMID: 24262954)
Dysphagia. 2015 Oct;30(5):521-8. (PMID: 26050238)
Dysphagia. 2013 Jun;28(2):226-33. (PMID: 23271165)
Sleep. 1991 Dec;14(6):540-5. (PMID: 1798888)
Laryngoscope. 2010 Mar;120(3):643-8. (PMID: 19941283)

Keywords: Deglutition disorders; Obstructive sleep apnea; Polysomnography

Date Created: 20210422 Date Completed: 20211123 Latest Revision: 20211123

20250114

PMC8061009

10.1186/s12931-021-01702-2

33882921