4.3 Article

Laryngopharyngeal reflux and dysphagia in patients with obstructive sleep apnea: is there an association?

Journal

SLEEP AND BREATHING
Volume 23, Issue 2, Pages 619-626

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s11325-019-01844-0

Keywords

Obstructive sleep apnea; Dysphagia; Laryngopharyngeal reflux

Funding

  1. Federal Brazilian Agency CAPES

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Introduction There is evidence that patients with obstructive sleep apnea (OSA) tend to have a high prevalence of laryngopharyngeal reflux (LPR) and dysphagia. These diseases are known to share the same risk factors and may be interrelated, but there is a lack of studies evaluating their co-occurrence. Objectives To evaluate whether the presence of signs and symptoms suggestive of LPR may be associated with the presence of dysphagia in patients with moderate and severe obstructive sleep apnea (OSA), as well as assess the additional impact of these diseases on quality of life in patients with OSA. Methods Seventy adult patients with moderate or severe OSA were included in the study. The RSI (Reflux Symptom Index) and Swallowing Quality of Life (SWAL-QOL) in dysphagia questionnaires were administered, laryngoscopy was performed to calculate the Reflux Finding Score (RFS), and fiber-optic endoscopic evaluation of swallowing (FEES) was conducted. Results The prevalence of LPR was 59.7%, and the prevalence of dysphagia was 27.3%. The association between LPR and dysphagia was present in 17.9% of patients, but with no statistically significant difference. Lower SWAL-QOL scores were observed in several domains in patients with LPR and in only one domain in patients with evidence of dysphagia on FEES. Conclusions Although 17.9% of patients presented with findings suggestive of concomitant LPR and dysphagia, there was no statistically significant association between these two conditions. Patients with LPR had worse scores in several domains of dysphagia-related quality of life, while FEES evidence of dysphagia was associated with worse quality of life in only one domain.

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