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Laryngopharyngeal reflux and dysphagia in patients with obstructive sleep apnea: is there an association?

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Abstract

Introduction

There is evidence that patients with obstructive sleep apnea (OSA) tend to have a high prevalence of laryngopharyngeal reflux (LPR) and dysphagia. These diseases are known to share the same risk factors and may be interrelated, but there is a lack of studies evaluating their co-occurrence.

Objectives

To evaluate whether the presence of signs and symptoms suggestive of LPR may be associated with the presence of dysphagia in patients with moderate and severe obstructive sleep apnea (OSA), as well as assess the additional impact of these diseases on quality of life in patients with OSA.

Methods

Seventy adult patients with moderate or severe OSA were included in the study. The RSI (Reflux Symptom Index) and Swallowing Quality of Life (SWAL-QOL) in dysphagia questionnaires were administered, laryngoscopy was performed to calculate the Reflux Finding Score (RFS), and fiber-optic endoscopic evaluation of swallowing (FEES) was conducted.

Results

The prevalence of LPR was 59.7%, and the prevalence of dysphagia was 27.3%. The association between LPR and dysphagia was present in 17.9% of patients, but with no statistically significant difference. Lower SWAL-QOL scores were observed in several domains in patients with LPR and in only one domain in patients with evidence of dysphagia on FEES.

Conclusions

Although 17.9% of patients presented with findings suggestive of concomitant LPR and dysphagia, there was no statistically significant association between these two conditions. Patients with LPR had worse scores in several domains of dysphagia-related quality of life, while FEES evidence of dysphagia was associated with worse quality of life in only one domain.

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Funding

Fabio Caparroz has received financial support from Federal Brazilian Agency CAPES for the study.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), Sao Paulo, Brazil

    Fabio Caparroz, Milena Campanholo, Renato Stefanini, Tatiana Vidigal, Leonardo Haddad & Fernanda Haddad

  2. Department of Psychobiology, Instituto do Sono, Federal University of São Paulo (UNIFESP), Sao Paulo, Brazil

    Lia Rita Bittencourt & Sergio Tufik

Authors
  1. Fabio Caparroz
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  2. Milena Campanholo
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  3. Renato Stefanini
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  4. Tatiana Vidigal
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  6. Lia Rita Bittencourt
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  7. Sergio Tufik
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  8. Fernanda Haddad
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All authors have seen and approved final version of the manuscript.

Corresponding author

Correspondence to Fabio Caparroz.

Ethics declarations

The number of Research Ethics Committee approval was 195196 (report 35375814.0/0000.5505).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures of this study were in accordance with the ethical standards of the National Research Committee (Plataforma Brasil) and Institutional Ethics Committee (Escola Paulista de Medicina/Federal University of Sao Paulo). They were also in accordance with 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all participants of the study.

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The work was performed at Department of Otorhinolaryngology and Head and Neck Surgery—Federal University of São Paulo—UNIFESP—Brazil.

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Caparroz, F., Campanholo, M., Stefanini, R. et al. Laryngopharyngeal reflux and dysphagia in patients with obstructive sleep apnea: is there an association?. Sleep Breath 23, 619–626 (2019). https://doi.org/10.1007/s11325-019-01844-0

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  • DOI: https://doi.org/10.1007/s11325-019-01844-0

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