Relationship between Quality of Life and Swallowing in Hypertensive Individuals with Obstructive Sleep Apnea.

Abstract

Introduction: 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.

Objective: 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.

Methods: 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).

Results: 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.

Conclusion: 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.