Muniz Carla Rocha, Borges Thalyta Georgia Vieira, Ferreira Flavia Rodrigues, Brendim Mariana Pinheiro, Muxfeldt Elizabeth Silaid
Faculty of Medicine, Department of Internal Medicine, Post graduate Program in Internal Medicine, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, 9º andar, sala 9E11, Ilha do Fundão CEP, Rio de Janeiro, RJ, 21941-590, Brazil.
Dysphagia. 2024 Nov 16. doi: 10.1007/s00455-024-10783-2.
Obstructive sleep apnea (OSA) is closely associated with resistant hypertension (RHTN). Individuals with OSA may have sensory and muscular alterations in pharyngolaryngeal structures, potentially resulting in oropharyngeal dysphagia.
One objective of this study was to assess and compare the quality of life (QoL) and swallowing ability of resistant hypertensive patients with and without OSA. Another objective was to evaluate the relationship between QoL and changes in swallowing in patients with RHTN and OSA.
This work was an analytical observational study with a cross-sectional design that included resistant hypertensive patients who were undergoing polysomnography (the gold standard exam for the diagnosis of OSA), fiberoptic endoscopic evaluation of swallowing (FEES), dysphagia risk assessment (Eating Assessment Tool - EAT-10) and QoL assessment in swallowing (Swal-Qol).
Of the 65 participants, 13 (20%) did not have OSA, 13 (20%) had mild OSA, 18 (27.7%) had moderate OSA, and 21 (32.2%) had severe OSA. Compared with those without OSA, patients with OSA had lower swallowing QoL scores ("burden", "symptoms", and "mental health"). Furthermore, pre premature leakage, onset of the pharyngeal phase in the pyriform sinus, laryngeal penetration, pharyngeal residue and oropharyngeal dysphagia were more prevalent among patients with OSA.
Resistant hypertensive patients with OSA have a greater prevalence of changes in swallowing and worse Swal-QoL scores than those without OSA, although such changes were not shown in the EAT-10. In addition, Swal-Qol is related to swallowing safety impairments among these individuals.
阻塞性睡眠呼吸暂停（OSA）与难治性高血压（RHTN）密切相关。患有OSA的个体可能在咽喉结构中存在感觉和肌肉改变，这可能导致口咽吞咽困难。
本研究的一个目的是评估和比较患有和未患有OSA的难治性高血压患者的生活质量（QoL）和吞咽能力。另一个目的是评估RHTN和OSA患者的QoL与吞咽变化之间的关系。
这项工作是一项采用横断面设计的分析性观察研究，纳入了正在接受多导睡眠图检查（OSA诊断的金标准检查）、纤维内镜吞咽评估（FEES）、吞咽困难风险评估（饮食评估工具 - EAT - 10）和吞咽生活质量评估（Swal - Qol）的难治性高血压患者。
在65名参与者中，13名（20%）没有OSA，13名（20%）患有轻度OSA，18名（27.7%）患有中度OSA，21名（32.2%）患有重度OSA。与没有OSA的患者相比，患有OSA的患者吞咽QoL评分（“负担”、“症状”和“心理健康”）较低。此外，过早渗漏、梨状窦咽部阶段的开始、喉穿透、咽部残留和口咽吞咽困难在患有OSA的患者中更为普遍。
与没有OSA的患者相比，患有OSA的难治性高血压患者吞咽变化的患病率更高，Swal - QoL评分更差，尽管在EAT - 10中未显示出此类变化。此外，Swal - Qol与这些个体的吞咽安全受损有关。
