To investigate the impact of obstructive sleep apnea syndrome (OSAS) on the olfactory and gustatory functions, and the potential mechanisms affecting olfactory and gustatory functions.
Materials and methods
A total of 120 men between the ages of 41 and 70 (mean age (SD) = 56 ± 7.5) were divided into three groups according to polysomnography results: snoring group, mild to moderate OSAS group, and severe OSAS group. Olfactory and gustatory functions were evaluated by the Sniffin’ Sticks test and the triple-drop method, respectively. Otorhinolaryngologic examination, as well as sleep and quality of life questionnaires, were completed by all subjects one day before or after polysomnography.
There was a significant difference in odor thresholds (THR), odor discrimination (OD), odor identification (OI), thresholds-discrimination-identification (TDI) (p < 0.001, p < 0.001, p = 0.003, p < 0.001), and total taste score (p = 0.004, p = 0.021, p = 0.006) in all three groups. Of the subjects in the OSAS group, 43 (54%) exhibited olfactory dysfunction, including 18 subjects (45%) in the mild to moderate group and 25 subjects (63%) in the severe group. Significant negative correlations were found between all olfactory parameters and polysomnography parameters. Furthermore, a negative correlation was present between the total taste scores and the apnea-hypopnea index (AHI).
Men with OSAS exhibited impairment in olfactory and gustatory functions. Significant correlations were found between AHI and olfactory parameters, as well as between AHI and total taste scores.
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Body mass index
Percentage of time with oxygen saturation below 90%
Epworth Sleepiness Questionnaire
- LSaO2 :
The lowest oxygen saturation
Montreal Cognitive Assessment
Mean arterial oxygen desaturation
- MSaO2 :
Mean arterial oxygen saturation
Obstructive sleep apnea syndrome
Positive airway pressure
The MOS 36-item short-form health survey
Terry Y, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239. https://doi.org/10.1164/rccm.2109080
Chami HA, Resnick HE, Quan SF, Gottlieb DJ (2011) Association of incident cardiovascular disease with progression of sleep-disordered breathing. Circulation 123:1280–1286. https://doi.org/10.1161/CIRCULATIONAHA.110.974022
McCall WV, Harding D, O’Donovan C (2006) Correlates of depressive symptoms in patients with obstructive sleep apnea. J Clin Sleep Med 2(04):424–426
Salihoğlu M, Kendirli MT, Altundağ A, Tekeli H, Sağlam M, Çayönü M, Şenol MG, Özdağ F (2014) The effect of obstructive sleep apnea on olfactory functions. Laryngoscope 124:2190–2194. https://doi.org/10.1002/lary.24565
Günbey E, Güzel A, Karlı R, Ünal R (2015) The relationships between the clinical and polysomnographic findings and the olfactory function in patients with obstructive sleep apnea syndrome. Sleep Breath 19:1301–1307. https://doi.org/10.1007/s11325-015-1165-3
Walliczek-Dworschak U, Cassel W, Mittendorf L, Pellegrino R, Koehler U, Güldner C, Dworschak POG, Hildebrandt O, Daniel H, Günzel T, Teymoortash A, Hummel T (2017) Continuous positive air pressure improves orthonasal olfactory function of patients with obstructive sleep apnea. Sleep Med 34:24–29. https://doi.org/10.1016/j.sleep.2017.02.018
Koseoglu S, Derin S, Yilmaz M, Kutlu G, Sahan M (2017) Does positive airway pressure therapy improve olfactory function? Int Forum Allergy Rhinol 7:557–560. https://doi.org/10.1002/alr.21923
Croy I, Nordin S, Hummel T (2014) Olfactory disorders and quality of life--an updated review. Chem Senses 39:185–194. https://doi.org/10.1093/chemse/bjt072
Skrandies W, Zschieschang R (2015) Olfactory and gustatory functions and its relation to body weight. Physiol Behav 142:1–4. https://doi.org/10.1016/j.physbeh.2015.01.024
Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14(6):540–545. https://doi.org/10.1093/sleep/14.6.540
Partinen M, Gislason T (1995) Basic Nordic Sleep Questionnaire (BNSQ): a quantitated measure of subjective sleep complaints. J Sleep Res 4:150–155. https://doi.org/10.1111/j.1365-2869.1995.tb00205.x
Berry RB, Brooks R, Gamaldo C, Harding SM, Lloyd RM, Quan SF, Troester MT, Vaughn BV (2017) AASM scoring manual updates for 2017 (version 2.4). J Clin Sleep Med 13(05):665–666. https://doi.org/10.5664/jcsm.6576
Sateia MJ (2014) International classification of sleep disorders. Chest 146(5):1387–1394. https://doi.org/10.1378/chest.14-0970
Hummel T, Kobal G, Gudziol H, Mackay-Sim A (2007) Normative data for the “Sniffin’ Sticks” including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol 264:237–243. https://doi.org/10.1007/s00405-006-0173-0
Gudziol H, Hummel T (2007) Normative values for the assessment of gustatory function using liquid tastants. Acta Otolaryngol 127:658–661. https://doi.org/10.1080/00016480600951491
Doty RL (2012) Olfactory dysfunction in Parkinson disease. Nat Rev Neurol 8:329–339. https://doi.org/10.1038/nrneurol.2012.80
Rolheiser TM, Fulton HG, Good KP, Fisk JD, Mckelvey JR, Scherfler C, Khan NM, Leslie RA, Robertson HA (2011) Diffusion tensor imaging and olfactory identification testing in early-stage Parkinson’s disease. J Neurol 258:1254–1260. https://doi.org/10.1007/s00415-011-5915-2
Daurat A, Huet N, Tiberge M (2010) Metamemory beliefs and episodic memory in obstructive sleep apnea syndrome. Psychol Rep 107:289–302. https://doi.org/10.2466/10.13.20.22.PR0.107.4.289-302
Barnes DC, Wilson DA (2014) Sleep and olfactory cortical plasticity. Front Behav Neurosci 8:134. https://doi.org/10.3389/fnbeh.2014.00134
Wallace A, Bucks RS (2013) Memory and obstructive sleep apnea: a meta-analysis. Sleep 36:203. https://doi.org/10.5665/sleep.2374
Lévy P, J-L P, Arnaud C, Tamisier R, J-C B, Dematteis M, Godin-Ribuot D, Ribuot C (2008) Intermittent hypoxia and sleep-disordered breathing: current concepts and perspectives. Eur Respir J 32:1082–1095. https://doi.org/10.1183/09031936.00013308
Daurat A, Foret J, Bretdibat JL, Fureix C, Tiberge M (2008) Spatial and temporal memories are affected by sleep fragmentation in obstructive sleep apnea syndrome. J Clin Exp Neuropsychol 30:91–101. https://doi.org/10.1080/13803390701236116
Hedner M, Larsson M, Arnold N, Zucco GM, Hummel T (2010) Cognitive factors in odor detection, odor discrimination, and odor identification tasks. J Clin Exp Neuropsychol 32:1062–1067. https://doi.org/10.1080/13803391003683070
Larsson M, Finkel D, Pedersen NL (2000) Odor identification: influences of age, gender, cognition, and personality. J Gerontol Ser B Psychol Sci Soc Sci 55:P304–P310. https://doi.org/10.1093/geronb/55.5.p304
Ferini-Strambi L, Baietto C, Gioia MRD, Castaldi P, Castronovo C, Zucconi M, Cappa SF (2016) Cognitive dysfunction in patients with obstructive sleep apnea (OSA): partial reversibility after continuous positive airway pressure (CPAP). Brain Res Bull 61:87–92. https://doi.org/10.1016/s0361-9230(03)00068-6
Magliulo G, De Vincentiis M, Iannella G, Ciofalo A, Pasquariello B, Manno A, Angeletti D, Polimeni A (2018) Olfactory evaluation in obstructive sleep apnoea patients. Acta Otorhinolaryngol Ital 38:338–345. https://doi.org/10.14639/0392-100X-1981
Vennemann MM, Hummel T, Berger K (2008) The association between smoking and smell and taste impairment in the general population. J Neurol 255:1121–1126. https://doi.org/10.1007/s00415-008-0807-9
Etter JF, Ussher M, Hughes JR (2013) A test of proposed new tobacco withdrawal symptoms. Addiction 108:50–59. https://doi.org/10.1111/j.1360-0443.2012.03981.x
Thuerauf N, Kaegler M, Renner B, Barocka A, Kobal G (2000) Specific sensory detection, discrimination, and hedonic estimation of nicotine enantiomers in smokers and nonsmokers: are there limitations in replacing the sensory components of nicotine? J Clin Psychopharmacol 20:472–478. https://doi.org/10.1097/00004714-200008000-00012
Liu G, Zong G, Doty RL, Sun Q (2016) Prevalence and risk factors of taste and smell impairment in a nationwide representative sample of the US population: a cross-sectional study. BMJ Open 6:e13246. https://doi.org/10.1136/bmjopen-2016-013246
Yenigun A, Degirmenci N, Goktas SS, Dogan R, Ozturan O (2019) Investigation of smell and taste function in patients with obstructive sleep apnoea syndrome. J Laryngol Otol 133:376–379. https://doi.org/10.1017/S0022215119000768
Heiser C, Zimmermann I, Sommer JU, Hormann K, Herr RM, Stuck BA (2013) Pharyngeal chemosensitivity in patients with obstructive sleep apnea and healthy subjects. Chem Senses 38:595–603. https://doi.org/10.1093/chemse/bjt031
Kimoff R, Sforza E, Champagne V, Ofiara L, Gendron D (2001) Upper airway sensation in snoring and obstructive sleep apnea. Am J Respir Crit Care Med 164:250–255. https://doi.org/10.1164/ajrccm.164.2.2010012
Henke KG, Sullivan CE (1993) Effects of high-frequency oscillating pressures on upper airway muscles in humans. J Appl Physiol 75:856. https://doi.org/10.1152/jappl.19220.127.116.116
Suratt PM, Dee P, Atkinson RL, Armstrong P, Wilhoit SC (1983) Fluoroscopic and computed tomographic features of the pharyngeal airway in obstructive sleep apnea. Am Rev Respir Dis 127:487–492. https://doi.org/10.1164/arrd.1918.104.22.1687
Pedersen AM, Bardow A, Beier Jensen S, Nauntofte B (2010) Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion. Oral Dis 8:117–129. https://doi.org/10.1034/j.1601-0825.2002.02851.x
We thank all the patients and the staff from the Department of Otolaryngology and sleep medical center, Beijing Anzhen Hospital, China, who have participated in this study. We also thank Dr. Richard L Doty and Akshay Tangutur (University of Pennsylvania) for proofreading the manuscript.
The National Natural Science Foundation of China (81870335, 81670903) and the Capital’s Funds for Health Improvement and Research (2018-2-2065) supported this study.
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The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Liu, Y., Fang, F., Zhan, X. et al. The impact of obstructive apnea sleep syndrome on chemical function. Sleep Breath 24, 1549–1555 (2020). https://doi.org/10.1007/s11325-020-02022-3
- Obstructive sleep apnea syndrome
- Olfactory dysfunction
- Gustatory dysfunction
- Cognitive dysfunctions
- Peripheral neurodegeneration