Objective: Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder that can have a significant impact on the quality of life. According to recent studies, some OSAS patients exhibit swallowing abnormalities, such as the premature entry of food into the hypopharynx, and laryngeal penetration. We aimed to evaluate the swallowing function of OSAS patients and compare swallowing-related parameters between OSAS severity groups through a video fluoroscopic swallowing study (VFSS). Methods: Ninety-two participants with a symptom of snoring were enrolled in this retrospective study. Eighty-four participants were diagnosed with OSAS by polysomnography. The subjects were evaluated using the apnea-hypopnea index (AHI) and divided into four groups, namely non-OSAS, mild, moderate, and severe OSAS. Since all patients reported choking symptoms, they underwent VFSS and were evaluated for penetration or aspiration. The temporal parameters evaluated were oral transit time, pharyngeal transit time, and pharyngeal delay time. The movement parameters assessed were the distance, duration, and velocity of laryngeal elevation (LE). Results: Penetration was detected in six OSAS patients, but aspiration was not observed in any patient. Seventy-four patients showed vallecular and pyriform sinus residue, although the amount was not significantly large. There was no significant difference in any of the temporal parameters between the groups except pharyngeal transit time with 10 ml of yogurt. In the Pearson’s correlation and multivariate linear regression analysis, LE distance and LE velocity, both correlated with AHI scores with 5 ml of liquid, 10 ml of liquid, and 10 ml of yogurt, respectively. Conclusion Severe OSAS patients showed longer and faster hyolaryngeal movement while swallowing, which may be a compensatory movement to prevent penetration or aspiration.

BACKGROUND AND OBJECTIVES: Obesity is one of the most important risk factors for obstructive sleep apnea (OSA). There is limited evidence regarding the obesity-related anthropometric characteristics of Korean patients. MATERIALS AND METHOD: Medical records of 984 patients referred to 3 tertiary referral hospitals for habitual snoring or sleep apnea were analyzed. We defined OSA as apnea-hypopnea index (AHI) ≥5 and analyzed data to determine the anthropometric characteristics of patients with OSA such as neck circumference (NC), waist circumference (WC), hip circumference (HC), and waist to hip ratio (WHR). RESULTS: A total of 952 patients (719 men) were included in the analysis. The main findings were: 1) BMI, WC, NC, HC, and WHR were greater among patients with OSA than among controls (AHI < 5); 2) for both sexes, the proportion of patients with an OSA diagnosis increased with age; it increased steeply for women aged >50 years; 3) WC and WHR were most strongly correlated with AHI for men and women, respectively. CONCLUSION: OSA is associated with anthropometric characteristics, although different patterns were observed between men and women. OSA was more strongly associated with NC or WC among men and with WHR among women.
Body Mass Index ; Diagnosis ; Female ; Hip ; Humans ; Male ; Medical Records ; Methods ; Neck ; Obesity ; Risk Factors ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tertiary Care Centers ; Waist Circumference ; Waist-Hip Ratio

Background: and Purpose: In this study we aimed to find the association between neuropsychological performance and body mass index (BMI) in patients with mild cognitive impairment (MCI). In addition, we investigated the effects of the apolipoprotein E (APOE) genotype in the relationship between the BMI and cognition in MCI. Methods: We enrolled a cohort of 3,038 subjects with MCI aged 65–90 from the Clinical Research Center for Dementia of South Korea and a dementia cohort of the Ewha Womans University Mokdong Hospital. MCI patients were classified into three subgroups according to the Asian standard of BMI. We compared cognitive performances between groups by one-way analysis of variance. To investigate the effects of the APOE genotype, we used multivariate linear regression models after adjusting for possible confounders. Results: Even though normal BMI groups were younger, had more females, and had less comorbidities, the higher BMI groups had better cognitive functions. Among subjects with APOE ε4 carriers, there was a positive relationship between the BMI and the memory task alone. Conclusions Our findings suggested that higher BMI in patients with MCI were associated with better cognitive performance. The effects of the APOE ε4 genotype in the associations between BMI and cognition were distinguishing. Therefore, according to physical status, APOE ε4 genotype-specific strategies in the assessments and treatments may be necessary in elderly patients with MCI.