Does our swallow go to sleep? Changes in swallow function during sleep and implications for symptoms

Area of Science:

• Physiology
• Gerontology
• Respiratory Medicine

Background:

• Swallowing (deglutition) is crucial for airway protection by clearing pharyngeal matter.
• Respiratory phase patterns during swallowing are vital for preventing aspiration.
• Sleep significantly alters swallowing frequency and associated respiratory patterns.

Purpose of the Study:

• To review sleep-related swallowing and respiratory patterns.
• To examine the implications of these patterns on airway protection and pathophysiology.

Main Methods:

• Literature review of studies on swallowing and respiration during sleep.
• Analysis of deglutition frequency across different sleep stages.
• Examination of respiratory phase patterns associated with sleep-related deglutition.

Main Results:

• Swallowing is infrequent during sleep, decreasing with deeper sleep stages.
• In younger adults, sleep swallowing is typically followed by breathing cessation, reducing aspiration risk.
• Older adults exhibit extremely reduced swallowing frequency and adverse respiratory patterns during sleep, increasing aspiration risk.

Conclusions:

• Sleep-related swallowing and respiratory patterns are compromised in older adults.
• Reduced pharyngeal and esophageal clearance during sleep exacerbates aspiration risk in the aged.
• These altered patterns are linked to aspiration-related diseases like pneumonia, particularly in the elderly with presbyphagia.