Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan.
Curr Opin Otolaryngol Head Neck Surg. 2020 Dec;28(6):392-400. doi: 10.1097/MOO.0000000000000670.
Swallowing is a vital function and the clearance of the pharynx by deglutition, which removes matter that could be aspirated, and the respiratory phase patterns associated with deglutition are important in protecting the airways and lungs against aspiration. This article reviews swallowing and respiratory phase patterns associated with deglutition during sleep and their implications for pathophysiology.
During sleep, swallowing is infrequent and absent for long periods. The deeper the sleep stage, the lower the mean deglutition frequency. However, in healthy younger adults, sleep-related deglutition is almost always followed by arrested breathing and expiration, reducing the risk of aspiration. Deglutition is extremely infrequent as well as absent for long periods in the aged. Consequently, clearance of the pharynx and esophagus by deglutition was extremely reduced during sleep in the aged. Furthermore, respiratory phase patterns associated with deglutition displayed adverse patterns during sleep in the aged.
Due to the complexity of swallowing processes, many adverse health conditions can influence swallowing functions during sleep, especially in the aged. Sleep-related deglutition and respiratory phase patterns may adversely influence aspiration-related diseases such as aspiration pneumonia, especially in the aged not only with primary but also with secondary presbyphagia.
吞咽是一项重要的生理功能，通过吞咽清除可能被吸入的物质，与吞咽相关的呼吸时相模式对于保护气道和肺部免受吸入性损伤至关重要。本文综述了睡眠期间吞咽和呼吸时相模式及其与病理生理学的关系。
在睡眠期间，吞咽频率较低且间隔时间较长。睡眠深度越深，平均吞咽频率越低。然而，在健康的年轻成年人中，睡眠相关的吞咽几乎总是伴随着呼吸暂停和呼气终止，从而降低了吸入的风险。在老年人中，吞咽也非常罕见且长时间不发生。因此，在睡眠期间，老年人通过吞咽清除咽部和食管的能力大大降低。此外，与吞咽相关的呼吸时相模式在老年人的睡眠中呈现出不良模式。
由于吞咽过程的复杂性，许多不良健康状况会影响睡眠期间的吞咽功能，尤其是在老年人中。睡眠相关的吞咽和呼吸时相模式可能会对与吸入相关的疾病产生不利影响，如吸入性肺炎，尤其是在既有原发性吞咽困难又有继发性吞咽困难的老年人中。
