Sleep-related deglutition and respiratory phase patterns in the aged with obstructive sleep apnea under CPAP therapy

Abstract

Background: Respiratory phase patterns associated with deglutition and clearance of pharynx by deglutition are important in protecting airways and lungs against aspiration.

Aims/objectives: Sleep-related deglutition and respiratory phase patterns in the aged with obstructive sleep apnea (OSA) before and under CPAP therapy were investigated.

Materials and methods: Ten aged adults with severe OSA under CPAP therapy were examined by polysomnography and surface electromyography of the muscles related to swallowing and compared with the same patients before CPAP therapy.

Results: Under CPAP therapy, swallowing was also infrequent and absent for long periods. The deeper the sleep stage, the lower the deglutition frequency. The median number of swallows per hour during total sleep time was 1.5 and the median longest deglutition-free period was 74.5 min. Swallows following and/or followed by inspiration, which were observed a great deal before CPAP therapy, were markedly reduced. On the other hand, swallows following and/or followed by expiration markedly increased. Approximately, 73.5% of swallows occurred after expiration and approximately 66.8% were followed by expiration. Respiratory phase patterns associated with sleep-related deglutition improved under CPAP.

Conclusions/significance: CPAP therapy improved sleep-related deglutition and respiratory phase patterns in the aged with OSA.

Chinese abstract

背景：与吞咽和通过吞咽清除咽喉相关的呼吸相模式对保护呼吸道和肺部免受吸入性疾病的影响非常重要。

目的：研究老年阻塞性睡眠呼吸暂停（OSA）患者CPAP治疗前后的与睡眠相关的吞咽和呼吸相模式。

材料与方法：对10例老年重度阻塞性睡眠呼吸暂停综合征（OSA）患者进行多导睡眠图和吞咽相关肌表面肌电图检查, 并与CPAP之前的同样患者进行比较。

结果：在CPAP治疗下, 吞咽在长时间内不频繁甚至不见。睡眠阶段越深, 吞咽频率越低。在整个睡眠时间中, 每小时吞咽的中位数为1.5, 最长无吞咽的中位数为74.5分钟。在CPAP治疗前观察到的大量吞咽和/或吸气后的吞咽明显减少。另一方面, 呼气前后的吞咽明显增加。约73.5%的吞咽发生在呼气后, 约66.8%的吞咽发生在呼气前。CPAP改善了睡眠相关吞咽的呼吸相模式。

结论和意义：CPAP治疗可改善老年OSA患者的睡眠相关吞咽和呼吸相模式。

Keywords:

• Sleep-related deglutition
• respiratory phase pattern
• sleep
• the aged
• obstructive sleep apnea
• CPAP therapy

Disclosure statement

The authors report no conflict of interest. The authors alone are response for content and writing of this article.