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Swallowing and breathing patterns during sleep in patients with obstructive sleep apnea

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Abstract

Purpose

The aims of this study were to determine the frequencies of swallowing and swallowing associated with arousals during sleep in patients with obstructive sleep apnea (OSA) and to determine whether these were associated with the severity of OSA and differed according to the preceding breathing route.

Methods

Standard audio-video polysomnography including an evaluation of swallowing-related elevation of the thyroid cartilage and breathing route (i.e., nasal or oronasal) was undertaken in an academic sleep laboratory. Fifty-six patients were analyzed (13 non-OSA patients, 17 mild, 10 moderate, and 16 severe OSA).

Results

The frequency of swallowing per hour of sleep was significantly higher in the severe OSA patients when compared to mild OSA patients (mild OSA, 3.1/h and severe OSA, 8.4/h). This was mainly due to the significantly higher frequency of swallowing associated with a respiratory event-related arousal in the severe OSA patients when compared to non- and mild OSA patients (non-OSA, 0.6/h; mild OSA, 1.0/h; severe OSA, 6.0/h), especially when swallowing was preceded by oronasal breathing (non-OSA, 0.2/h; mild OSA, 0.4/h; severe OSA, 4.2/h).

Conclusions

Swallowing frequency during sleep can increase with increasing OSA severity in most OSA patients. These events are predominately associated with respiratory event-related arousals and are more frequent when preceded by oronasal breathing. The observed swallowing under high ventilatory needs may compromise the maintenance of the pharynx as a conduit for airflow in OSA patients.

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Acknowledgments

The authors would like to thank the sleep technologists for their assistance in data collection, Mrs. Mary Wong for her assistance in the software and statistical analysis, Miss Sandra Harrison for her assistance in the preparation of experimental equipments, and Miss Adrian Carney for her editorial assistance in the final preparation of this manuscript. The first author was supported as a postdoctoral fellow, in part, by MITACS ACCELERATE BC.

Conflict of interest

The first author was supported as a postdoctoral fellow, in part, by MITACS ACCELERATE BC. None of the authors have any conflicts of interest associated with this study.

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Authors and Affiliations

  1. Department of Oral Health Sciences, The University of British Columbia, 2199 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada

    Kazutomo Yagi, Alan A. Lowe & Fernanda R. Almeida

  2. Department of Oral and Maxillofacial Prosthodontics and Oral Implantology, Institute of Health Biosciences, The University of Tokushima, 3-18-15 Kuramoto, 770-8504, Tokushima, Japan

    Kazutomo Yagi

  3. Department of Medicine, The University of British Columbia, 2211 Wesbrook Mall, V6T 2B5, Vancouver, BC, Canada

    Najib T. Ayas & John A. Fleetham

Authors
  1. Kazutomo Yagi
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  2. Alan A. Lowe
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  3. Najib T. Ayas
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  4. John A. Fleetham
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  5. Fernanda R. Almeida
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Corresponding author

Correspondence to Kazutomo Yagi.

Additional information

The institution at which the work was performed was the Faculty of Dentistry and University of British Columbia Hospital Sleep Disorder Program

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Yagi, K., Lowe, A.A., Ayas, N.T. et al. Swallowing and breathing patterns during sleep in patients with obstructive sleep apnea. Sleep Breath 19, 377–384 (2015). https://doi.org/10.1007/s11325-014-1031-8

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  • DOI: https://doi.org/10.1007/s11325-014-1031-8

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