Obstructive sleep apnea syndrome (OSAS) and swallowing function—a systematic review

Abstract

Objectives The purpose of this systematic review was to summarize and qualitatively analyze published evidence elucidating the prevalence of dysphagia and detail alterations in swallowing function in patients with OSAS. Methods Computerized literature searches were performed from four search engines. The studies were selected based on the inclusion and exclusion criteria. The studies were screened using Covidence (Cochrane tool) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards (PRISMA-2009). A total 2645 studies were initially retrieved, of which a total of 17 studies met inclusion criteria. Two reviewers, blinded to each other, evaluated level and strength of evidence using the Oxford Centre for Evidence-based Medicine Levels of Evidence and QualSyst, respectively. Results Dysphagia prevalence ranged from 16 to 78% among the eligible studies. Studies varied in operational definitions defining swallowing dysfunction (dysphagia) and method used to assess swallowing function. Approximately 70% of eligible studies demonstrated strong methodological quality. The majority of studies (n = 11; 65%) reported pharyngeal swallowing impairments in patients with OSAS, including delayed initiation of pharyngeal swallow and penetration/aspiration. Conclusion This systematic review describes swallowing function in patients with OSAS. However, due to the variability in defining OSAS and dysphagia, in the assessment method used to determine dysphagia, and heterogeneity of study designs, true prevalence is difficult to determine. Clinicians involved in the management of OSAS patients should employ validated assessment measures to determine if swallow dysfunction is present.

Alterations in the Swallowing Function According to the Severity of Obstructive Sleep Apnea Syndrome

“…There were no significant differences in temporal parameters among the groups except PTT with 10 ml that OSAS patients have impaired swallowing, such as premature bolus loss, residue in the hypopharynx, and laryngeal penetration 13,14,23,24 . The most frequently reported abnormality was premature spillage of food 9,10 .…”

“…Similarly, another study of FEES in OSAS patients demonstrated that 27.3% of patients had dysphagia 25 . However, despite the presence of objective swallowing abnormalities, OSAS patients did not voluntarily report symptoms of dysphagia 23,26 . In a recent study, 15% of OSAS patients reported symptoms of dysphagia 12 .…”

To Determine Pivotal Genes Driven by Methylated DNA in Obstructive Sleep Apnea Hypopnea Syndrome

“…OSAHS is a common breathing disorder, and its mechanisms in modulating this disease were still unclear [17]. Over the past decades, a large number of studies have shown that abnormal DNA methylation epigenetically silences genes necessary for the pathogenesis of human diseases.…”

From SARS-CoV-2 infection to COVID-19 disease: a proposed mechanism for viral spread to the lower airway based on in silico estimation of virion flow rates

“…One condition associated with dysphagia is obstructive sleep apnea (OSA) [27][28][29] , with increased nocturnal aspiration 30 and risk of aspiration pneumonia 31 . Based on the mechanism proposed by us for viral spread to the lungs, individuals with OSA would thus be expected to be at a higher risk for COVID-19.…”