Non-invasive Assessment of Swallowing and Respiration Coordination for the OSA Patient

Abstract

The objectives of this study are to investigate swallowing and its coordination with respiration in patients with obstructive sleep apnea (OSA). This is a prospective cohort study conducted in a tertiary referred Medical Center. A non-invasive method of assessing swallowing was used to detect the oropharyngeal swallowing parameters and the coordination with respiration during swallowing. The system used to assess swallowing detected: (1) movement of the larynx using a force-sensing resistor; (2) submental muscle activity using surface electromyography; and (3) coordination with respiration by measuring nasal airflow. Five sizes of water boluses (maximum 20 mL) were swallowed three times, and the data recorded and analyzed for each participant. Thirty-nine normal controls and 35 patients with OSA who fulfilled the inclusion criteria were recruited. The oropharyngeal swallowing parameters of the patients differed from the controls, including longer total excursion duration and shorter duration of submental muscles contraction. A longer swallowing respiratory pause (SRP), temporary coordination with respiration during swallowing, was demonstrated in the patients compared with the controls. The frequency of non-expiratory/expiratory pre- and postswallowing respiratory phase patterns of the patients was similar with the controls. There was significantly more piecemeal deglutition in OSA patients when clumping 10- and 20-mL water boluses swallowing together (p = 0.048). Oropharyngeal swallowing and coordination with respiration affected patients with OSA, and it could be detected using a non-invasive method. The results of this study may serve as a baseline for further research and help advance research methods in obstructive sleep apnea swallowing studies.

Non-invasive assessment determine the swallowing and respiration dysfunction in early Parkinson's disease

“…Using a non-invasive instrument, we previously demonstrated age-related changes in swallowing and the coordination with respiration [17], and we also demonstrated a delayed pharyngeal phase compensated by a longer SRP in patients with subacute unilateral stroke [18]. In patients with OSA without self-perceived dysphagia, subclinical dysphagia could also be detected using this objective and sensitive tool [16]. We suggest further studies with more data collected and detail analysis used on patients with different stages or severity of PD may provide baseline data to improve swallowing care and treatment protocols.…”

“…Our non-invasive electrophysiological swallowing and respiration assessment system was based on the BIOPAC MP100 system (BIOPAC System, Goleta, CA, USA). The sensors used to detect the bio-signals of swallowing and respiration, and the Force Sensing Resistor (FSR) fixation method are same as our previous research [16,19].…”

“…After two ECG adhesive electrodes were placed for submental sEMG, FSR sensors for the laryngeal excursion [16], and nasal cannula for respiration were appropriately placed on the subject. Each participant was then instructed to swallow five types of water bolus at room temperature, three times for each bolus, in the following order: 1 ml, 3 ml, 5 ml, 10 ml, and 20 ml.…”

Respiratory Phase and Lung Volume Patterns During Swallowing in Healthy Adults: A Systematic Review and Meta-Analysis

“…When articles compared disordered and nondisordered participants, only data from the nondisordered adults were included. Two articles that described respiratory phase before and after the swallow relative to bolus volume in an experimental control group were also included (Pinto et al, 2017;Wang et al, 2016). Review of the entire content of the 54 articles resulted in 37 studies that met inclusion criterion and were recommended for inclusion (see Figure 1).…”

Síndrome da apneia obstrutiva do sono e disfagia orofaríngea: aspectos miofuncionais, respiratórios e coordenação neuromuscular oral e laríngea

“…Entretanto, em cerca de metade dos pacientes, o exame demonstrou sinais de comprometimento da deglutição. As implicações clínicas estão relacionadas com o risco de aspiração de partículas de alimentos para as vias aéreas, uma vez que o paciente não percebe resíduos de alimento na faringe Wang et al (2016). submeteram 39 homens com SAOS, com média de idade de 37 anos e 35 homens de um grupo controle com média de idade de 39 anos a um sistema de monitoramento eletrofisiológico, para investigar a deglutição e sua coordenação com a respiração.…”