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

Ankita M Bhutada1, William A Broughton2, Kendrea L Focht Garand3

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This review found that dysphagia (swallowing difficulty) is common in patients with obstructive sleep apnea syndrome (OSAS), affecting 16-78% of individuals. Pharyngeal swallowing impairments were frequently reported.

Keywords:
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Area of Science:

  • Otolaryngology
  • Neurology
  • Gastroenterology

Background:

  • Obstructive sleep apnea syndrome (OSAS) is a prevalent condition affecting millions globally.
  • Swallowing dysfunction, or dysphagia, is increasingly recognized as a potential comorbidity in OSAS patients.
  • Understanding the prevalence and nature of dysphagia in OSAS is crucial for comprehensive patient management.

Purpose of the Study:

  • To systematically review and qualitatively analyze existing literature on the prevalence of dysphagia in patients with OSAS.
  • To detail the specific alterations in swallowing function observed in individuals with OSAS.

Main Methods:

  • Comprehensive literature searches were conducted across four databases.
  • Study selection adhered to strict inclusion/exclusion criteria, with screening via Covidence.
  • Seventeen studies met the criteria, and evidence levels were assessed using the Oxford Centre for Evidence-based Medicine criteria.

Main Results:

  • The prevalence of dysphagia in OSAS patients varied widely, ranging from 16% to 78% across studies.
  • Pharyngeal swallowing impairments, including delayed initiation and penetration/aspiration, were reported in 65% of the included studies.
  • A significant portion (approximately 70%) of the studies exhibited strong methodological quality, despite variations in definitions and assessment methods.

Conclusions:

  • This review highlights significant swallowing impairments in OSAS patients, but the true prevalence remains difficult to ascertain due to heterogeneity in definitions and assessment tools.
  • Variability in the operational definitions of OSAS and dysphagia, along with diverse assessment methodologies, complicates precise prevalence determination.
  • Clinicians managing OSAS patients are advised to utilize validated assessment tools to accurately identify and address potential swallow dysfunction.