Predictors of Patient-Reported Dysphagia and Reflux Symptoms in Obstructive Sleep Apnea

Abstract

Purpose: Despite the reported high prevalence of dysphagia and reflux, patients with obstructive sleep apnea (OSA) are not routinely screened for dysphagia or reflux during conventional OSA management. The purpose of this exploratory study was to (a) identify prevalences of dysphagia and reflux self-reported symptoms in patients with OSA and (b) determine associations between dysphagia and reflux symptoms and demographic and clinical variables. Method: A chart review was completed on 75 patients with treated OSA during routine medical management at a university-affiliated sleep center. All participants completed the 10-Item Eating Assessment Tool (EAT-10) and Reflux Symptom Index (RSI) questionnaires, which are patient-reported outcome measures (PROMs) of swallowing and reflux symptoms, respectively. Relevant demographic and clinical variables were extracted. A binary logistic regression was computed to examine the relationships between dysphagia and reflux PROMs and demographic and clinical variables. Result: Sixty-three participants met eligibility criteria ( M age = 64 years). In addition, 14% ( n = 9) and 11% ( n = 7) of patients with OSA syndrome reported swallowing and reflux symptoms, respectively. Among the demographic and clinical variables investigated, there were no significant predictive factors for EAT-10 scores. Age and apnea–hypopnea index were significant predictive factors for RSI scores. Conclusions: To our knowledge, this is the first preliminary study to investigate swallowing and reflux symptoms concurrently in OSA, as well as potential mitigating factors. Although our findings suggest a relatively low percentage of patients with OSA report dysphagia and reflux symptoms, the true prevalences of swallowing and reflux disorders may be higher based on previous evidence suggesting that pharyngeal afferent (sensory) dysfunction may cause patients to underestimate their symptoms.