Dysphagie und obstruktive Schlafapnoe (OSA) – Was ist die pathophysiologische Brücke?

Zusammenfassung

Patienten mit obstruktiver Schlafapnoe (OSA) und Schnarchen haben eine erhöhte Prävalenz an Schluckstörungen. Schlucken ist ein komplexer Vorgang, der einer exakten neuromuskulären Koordination bedarf. Sowohl bei der Atmung als auch beim Schluckvorgang wird der Pharynx gemeinsam genutzt. Der Schluckprozess kann in eine orale, pharyngeale und ösophageale Phase unterteilt werden. Mit dem Schluckreflex geht ein Anheben von Hyoid und Larynx einher, die Glottis verschließt den Eingang zum Larynx. Während der Schluckapnoe, die eine Atempause von 0,5–1,0 Sekunden umfasst, passiert der Bolus den pharyngealen Atemweg. Dysphagien sind mit schweren Komplikationen wie Aspiration und Pneumonie assoziiert. Obwohl die Pathophysiologie der Dysphagie bei OSA-Patienten unklar ist, gehen wir davon aus, dass sie auch ein Resultat der durch Vibration (Schnarchen) induzierten Störung der Sensomotorik des Oropharynx ist.

Abstract

There is a high prevalence of dysphagia among patients with obstructive sleep apnea (OSA) and snoring. Swallowing is a complex process requiring fine-tuned neuromuscular coordination. Breathing and swallowing share a common passage in the pharynx. Swallowing process can be divided into an oral, pharyngeal and esophageal phase. When the swallowing reflex starts, hyoid and larynx are pulled up and the glottis covers the entrance to larynx. During swallowing apnea, which is a respiration pause for about 0.5–1.0 seconds, the bolus passes pharyngeal airway. Dysphagia is associated with severe complications such as aspiration and pneumonia. Although the pathophysiology of dysphagia in OSA-patients is not clearly understood, we assume that dysphagia is also a result of sensory and motor changes in the oropharynx caused by snoring vibrations.

Schlüsselwörter

obstruktive Schlafapnoe - Schnarchen - Schlucken - Dysphagie - Aspiration

Keywords

obstructive sleep apnea - snoring - swallowing - dysphagia - aspiration

Publication History

Received: 07 February 2025

Accepted: 13 March 2025

Article published online:
01 April 2025

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