Modification of mastication and respiration during swallowing in the adult human

Abstract

1. The normal interactions between respiration, mastication, and swallowing were studied in seated adult humans. Respiratory movements and movements of the larynx were recorded with mercury-elastic strain gauges placed around the rib cage and neck. A rigid body containing infrared-emitting diodes (IREDs) was attached to the forehead, and a single IRED was applied to the chin. Jaw and head movements were transduced using the OPTOTRAK spatial motion analysis system. Recordings were made before, during, and after the mastication of pieces of carrot. 2. Movements of the larynx were used as a marker for swallowing. Measurements were made of the duration of masticatory and respiratory cycles, and the phase relationship between the two rhythms was determined. Deviations in masticatory and respiratory movements during swallowing were detected; the phases of the masticatory and respiratory cycles in which the deviations occurred were determined, and the interval between each deviation and the swallowing marker was calculated. 3. Three characteristic swallowing patterns were observed: interposed, terminal, and spontaneous. Interposed swallows occurred within a masticatory sequence, terminal swallows ended the sequence, and spontaneous swallows occurred sporadically between masticatory sequences. 4. Results revealed that mastication could have a profound effect on the respiratory rhythm in some subjects. One subject, whose data were excluded from further analyses, became apneic for a long period, followed by short and shallow breaths near the end of the masticatory sequence. In most subjects, respiratory rate increased during mastication and then dropped below baseline as soon as mastication ended. The end-inspiration diameter of the rib cage tended to decrease in the preswallow period and increase postmastication relative to baseline. 5. There was a weak but significant tendency for inspiration to begin during the jaw opening phase of mastication, but phase coupling did not become stronger as swallowing was approached. 6. Deviations in respiration during swallowing occurred during the late expiratory phase of the breathing cycle. Swallows within a masticatory sequence occurred most frequently during the early opening phase of the masticatory cycle, and terminal swallows occurred after the end of the sequence with the mandible in the resting, postural position. Swallowing temporarily reset both the masticatory and respiratory rhythms. Most swallows prolonged the duration of one or two respiratory cycles, however; swallows were often repetitive, and in some subjects two or three swallows fell within a single respiratory cycle, prolonging it for several seconds. 7. A tight temporal relationship was observed between deviations in respiration and the swallowing marker: all deviations occurred before or coincident with the marker. The time of deviations in mastication relative to the swallowing marker depended on swallow type. There was no link between the start of pauses in the two rhythms, suggesting that the commands from the swallowing central pattern generator to the other two pattern generators are independent. 8. We suggest that disordered coordination of mastication and swallowing with respiration may cause prolonged apnea in susceptible individuals.