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

  • Sleep Breathing Physiology and Disorders • Review
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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.

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Acknowledgments

The authors would like to acknowledge Ms. Rachel Fenskie for her assistance with initial search strategy.

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Authors and Affiliations

  1. Department of Speech Pathology and Audiology, University of South Alabama, 5721 USA, Drive North, Mobile, AL, 36688, USA

    Ankita M. Bhutada & Kendrea L. (Focht) Garand

  2. Department of Internal Medicine, University of South Alabama, 2451 University Hospital, Drive Mastin Building, Suite 400-L, Mobile, AL, 36617, USA

    William A. Broughton

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  1. Ankita M. Bhutada
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Contributions

All authors contributed to the study. Author’s AB and KG were involved in conceptualizing. The data extraction was performed by AB; quality assignment and consensus establishment were carried out by both AB and KG. The first draft was drafted by AB; and critical revisions and finalization of the paper were done by KG and WB.

Corresponding author

Correspondence to Kendrea L. (Focht) Garand.

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The authors declare that they have no conflicts of interests.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Presentation at Conference: This work was presented as a technical research session at the American Speech-Language-Hearing Association Annual Convention, November 21–23, 2019, Orlando, FL.

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Bhutada, A.M., Broughton, W.A. & (Focht) Garand, K.L. Obstructive sleep apnea syndrome (OSAS) and swallowing function—a systematic review. Sleep Breath 24, 791–799 (2020). https://doi.org/10.1007/s11325-020-02037-w

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  • DOI: https://doi.org/10.1007/s11325-020-02037-w

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