About one-sixth of people with obstructive sleep apnea (OSA) have shown symptoms of dysphagia. According to an analysis published in Respiratory Research, symptoms of dysphagia are independently associated with female gender, symptoms of OSA, anxiety / depression, gastroesophageal reflux disease (GERD), and excessive daytime sleepiness.
The researchers conducted a prospective single center study in outpatients with OSA who were referred to the Luigi Sacco University Hospital Sleep Clinic in Milan, Italy. They attempted (1) to evaluate the prevalence of dysphagia symptoms in people with OSA; (2) examine the association between symptoms of dysphagia and demographic and clinical variables; and (3) describe objective symptoms of dysphagia in symptomatic patients with OSA.
All study participants underwent cardiorespiratory polygraphy while sleeping at home and answered the Eating Assessment Tool (EAT-10) questionnaire to examine their symptoms of dysphagia. Individuals with a positive EAT-10 score were offered the opportunity to undergo an endoscopic fiber optic endoscopic assessment of swallowing (FEES) to verify the diagnosis of dysphagia.
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A total of 951 people with OSA completed EAT-10 and were enrolled in the study. Overall, 70% of the participants were men. The mean patient age was 62 years (range 51-71 years). The mean body mass index (BMI) was 28 (range 25 to 31); The mean apnea-hypopnea index was 19 (range 11-33). Obstructive sleep apnea was mild in 375 people, moderate in 297 people, and severe in 279 people.
Of the 951 people who completed the EAT-10 questionnaire, 141 reported symptoms of dysphagia. Female gender (odds ratio [OR]2.31); excessive daytime sleepiness (OR, 2.24); Number of OA symptoms (OR, 1.25); Anxiety / depression (OR, 1.89); and symptoms of GERD (OR, 2.75) were all significantly associated with symptoms of dysphagia (all P <0.05). Based on an EAT-10 score of 3 or higher, a total of 15% of patients with OSA had symptoms of dysphagia.
The presence of dysphagia was confirmed in 34 of the 35 symptomatic participants who agreed to undergo FEES. When the FEES findings of these 35 participants were compared with those of 27 age-matched, healthy controls, people with OSA showed a significantly lower position of the bolus at the start of swallowing (excluding solids), greater throat recession, and higher frequency and frequency regardless of the bolus type Severity of penetration and aspiration events (P <0.05).
A major limitation of the current study was the fact that the prevalence of dysphagia symptoms was based on an objective diagnosis through instrumental assessment. Using a patient-reported tool could have resulted in an underestimation of the true prevalence of dysphagia due to poor patient awareness.
The researchers concluded that the EAT-10 appears to be a sensitive tool for guiding the selection of patients with OSA who are potentially at high risk for dysphagia. Future studies that include other polysomnographic indices are warranted.
reference
Pizzorni N., Radovanovic D., Pecis M. et al. Symptoms of dysphagia in obstructive sleep apnea: prevalence and clinical correlates. Respir Res. 2021; 22 (1): 117. doi: 10.1186 / s12931-021-01702-2
This article originally appeared on Pulmonology Advisor
