Swallowing Function During Sleep in Patients with Head and Neck Cancer: A Polysomnographic Comparison with Matched...

Area of Science:

• Otolaryngology
• Sleep Medicine
• Deglutition Science

Background:

• Head and neck cancer (HNC) survivors often experience functional deficits.
• Pharyngolaryngeal dysfunction can impact both swallowing and airway patency.
• Impaired swallowing during sleep may increase aspiration risk and contribute to sleep-disordered breathing.

Purpose of the Study:

• To investigate pharyngolaryngeal function during sleep in patients with HNC compared to controls.
• To assess swallowing frequency, duration, muscle activity (EMG), and respiratory timing during sleep using polysomnography (PSG).
• To determine if HNC impacts swallowing parameters relevant to aspiration and airway stability.

Main Methods:

• Polysomnography (PSG) was used to monitor sleep and swallowing in 15 male HNC patients and matched controls.
• Key parameters assessed included swallowing frequency, duration, submental electromyographic (EMG) amplitude, and respiratory phase timing.
• Statistical analyses (Shapiro-Wilk, parametric/nonparametric tests) were performed with significance at p < 0.05.

Main Results:

• HNC patients showed significantly higher swallowing frequency during sleep (overall, REM, and non-REM).
• Swallowing duration was longer in HNC patients during wakefulness but not sleep.
• Submental EMG amplitude during swallowing decreased significantly during sleep in HNC patients, with more frequent respiratory pauses around swallowing events.

Conclusions:

• Pharyngolaryngeal swallowing function appears impaired during sleep in HNC patients.
• This dysfunction may link HNC-related muscle changes to obstructive sleep apnea (OSA) and increased aspiration risk.
• Early detection of OSA and targeted swallowing rehabilitation are crucial for improving airway safety and reducing complications in HNC survivors.