Sleep Stage Coordination Respiration and Swallowing: A Preliminary Study
Sleep Stage Coordination Respiration and Swallowing: A Preliminary Study
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睡眠阶段协调呼吸和吞咽：初步研究
DOI：
10.1007/s00455-016-9719-5
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发表时间：
2016
期刊：
影响因子：
2.6
通讯作者：
Almeida FR
中科院分区：
文献类型：
--
作者：
Okuno K;Nohara K;Takai E;Sakai T;Fleetham JA;Najib TA;Lowe AA;Ryan CF;Almeida FR
吞咽是保护气道的重要生理反应。虽然睡眠中的误吸可能导致吸入性肺炎，但其机制尚未阐明。我们通过在每个睡眠阶段将水注入健康年轻人的咽部来评估呼吸和吞咽之间的协调。7名正常受试者参加了这项研究。在多导睡眠图记录过程中，为了引起吞咽，我们在清醒状态和每个睡眠阶段通过鼻导管向咽部注射蒸馏水。我们评估了吞咽潜伏期、吞咽呼吸暂停时间、吞咽期间的呼吸阶段、吞咽次数和咳嗽。共录得79只燕子。与清醒状态（4.99 s）相比，第2阶段（10.05 s）和第3阶段（44.17 s）的中位吞咽潜伏期显著更高。第3阶段的吞咽潜伏期显示非常宽的四分位数范围。在两名受试者中，与其他受试者相比，结果主要是延长。不同睡眠阶段的吞咽呼吸暂停时间无显著差异。吞咽后吸气、重复吞咽和吞咽后咳嗽的存在在睡眠期间比清醒时更频繁。这项研究表明，呼吸和吞咽之间的协调作为一种防御机制，对吸入在睡眠中受损。我们的研究结果支持生理学的事实，即健康的成年人在睡眠期间吸入咽部分泌物。
Swallowing is an important physiological response that protects the airway. Although aspiration during sleep may cause aspiration pneumonia, the mechanisms responsible have not yet been elucidated. We evaluated the coordination between respiration and swallowing by infusing water into the pharynx of healthy young adults during each sleep stage. Seven normal subjects participated in the study. During polysomnography recordings, to elicit a swallow we injected distilled water into the pharynx during the awake state and each sleep stage through a nasal catheter. We assessed swallow latency, swallow apnea time, the respiratory phase during a swallow, the number of swallows, and coughing. A total number of 79 swallows were recorded. The median swallow latency was significantly higher in stage 2 (10.05 s) and stage 3 (44.17 s) when compared to awake state (4.99 s). The swallow latency in stage 3 showed a very wide interquartile range. In two subjects, the result was predominantly prolonged compared to the other subjects. There was no significant difference in the swallow apnea time between sleep stages. The presence of inspiration after swallowing, repetitive swallowing, and coughing after swallowing was more frequent during sleep than when awake. This study suggests that the coordination between respiration and swallowing as a defense mechanism against aspiration was impaired during sleep. Our results supported physiologically the fact that healthy adult individuals aspirate pharyngeal secretions during sleep.