Department of Internal Medicine, Graduate School of Life Dentistry at Niigata, Nippon Dental University, Niigata, Japan.
Center for Dental Sleep Medicine, Nippon Dental University Niigata Hospital, Niigata, Japan.
Sleep. 2022 Apr 11;45(4). doi: 10.1093/sleep/zsac036.
There are only a few reports on voluntary swallowing during sleep; therefore, this study aimed to propose a method for observing voluntary swallowing during sleep using polysomnography. The frequency of voluntary swallowing during sleep and the factors related to swallowing and aspiration during sleep were investigated.
Polysomnography records of 20 control subjects and 60 patients with obstructive sleep apnea (OSA) (mild, moderate, and severe groups; n = 20 each) were collected. Simultaneous increases in the electromyographic potentials of the submental and masseter muscles, termed coactivation, and declining oronasal airflow (SA) were extracted as "swallowing." The cough reflex that occurred during sleep was extracted as "aspiration." The frequency of swallowing events was compared among the different OSA severity groups. Subsequently, a multivariate regression analysis was performed.
The average frequency of coactivation with SA in control subjects was 4.1 events/h and that without SA was 1.7 events/h. These frequencies increased with the severity of OSA during non-REM sleep. The distance of the hyoid to the Frankfurt plane was associated with the frequency of coactivation with (β = 0.298, p = 0.017) as well as without SA (β = 0.271, p = 0.038). The frequency of coactivation without SA was associated with aspiration (B = 0.192, p = 0.042).
Our data provide new insights into the relationship between swallowing and aspiration during sleep. We found that the longer the distance from the hyoid bone to the Frankfurt plane, the higher the coactivation without SA, which could lead to aspiration during sleep.
Retrospective observational study of swallowing during sleep in obstructive sleep apnea patients using polysomnography, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000050460, UMIN000044187.
目前仅有少数关于睡眠中自主吞咽的报告，因此本研究旨在提出一种使用多导睡眠图观察睡眠中自主吞咽的方法。本研究调查了睡眠中自主吞咽的频率，以及与睡眠吞咽和吸入相关的因素。
收集 20 名对照受试者和 60 名阻塞性睡眠呼吸暂停（OSA）患者（轻度、中度和重度组，每组 20 名）的多导睡眠图记录。同时增加颏下和咬肌肌电图的肌电活动，称为协同收缩，并出现下降的口鼻气流（SA），被提取为“吞咽”。睡眠中发生的咳嗽反射被提取为“吸入”。比较不同 OSA 严重程度组之间吞咽事件的频率。随后进行多元回归分析。
对照组受试者有 SA 的协同收缩的平均频率为 4.1 次/h，无 SA 的协同收缩的平均频率为 1.7 次/h。这些频率在非快速眼动睡眠期间随着 OSA 的严重程度而增加。舌骨到法兰克福平面的距离与有 SA 的协同收缩频率（β=0.298，p=0.017）以及无 SA 的协同收缩频率（β=0.271，p=0.038）相关。无 SA 的协同收缩频率与吸入有关（B=0.192，p=0.042）。
我们的数据提供了睡眠中吞咽和吸入之间关系的新见解。我们发现，舌骨到法兰克福平面的距离越长，无 SA 的协同收缩就越高，这可能导致睡眠中的吸入。
使用多导睡眠图观察阻塞性睡眠呼吸暂停患者睡眠中吞咽的回顾性观察性研究，https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000050460，UMIN000044187。
