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Coordination of Swallowing and Breathing: How Is the Respiratory Control System Connected to the Swallowing System?

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Structure-Function Relationships in Various Respiratory Systems

Abstract

Coordination of swallowing and breathing is an important airway-protecting mechanism. Although it is regulated by the interaction between central pattern generators of swallowing and breathing within the brainstem, various factors modulate the coordination of swallowing and breathing. Swallowing normally occurs during expiration, and respiration after swallowing resumes with expiration. However, swallowing can occur immediately following inspiration (I-SW pattern), and respiration can resume with inspiration (SW-I pattern). Such atypical breathing–swallowing coordination occurs when the timing of swallows is inappropriate and tends to increase due to diseases and aging. In patients with chronic obstructive pulmonary disease (COPD), swallowing physiology is altered, and breathing–swallowing coordination is impaired. COPD patients with a higher frequency of I-SW and/or SW-I patterns have a higher frequency of exacerbations. Thus, we suggest that the impairment of breathing–swallowing coordination can cause exacerbations and may influence the prognosis of diseases. Two modalities, swallowing rehabilitation and low-level continuous positive airway pressure (CPAP), may ameliorate breathing–swallowing coordination. More studies are needed to elucidate whether such interventions improve outcomes.

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  1. Department of Physiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

    Yoshitaka Oku

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  1. Department of Respiratory Medicine, Tokyo Medical University, Division of Respiratory Medicine, Tohto Clinic, Kenko-Igaku Association, Tokyo, Japan

    Kazuhiro Yamaguchi

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Oku, Y. (2020). Coordination of Swallowing and Breathing: How Is the Respiratory Control System Connected to the Swallowing System?. In: Yamaguchi, K. (eds) Structure-Function Relationships in Various Respiratory Systems. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-15-5596-1_3

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