Skip to main content
SpringerLink
Log in

Sleep Apnea, Hypnotics, and Aspiration Pneumonia: Is There Any Association Between Sleep Apnea and Aspiration Pneumonia?

  • Chapter
  • First Online:
Aspiration Pneumonia

  • 1186 Accesses

Abstract

The association between swallowing dysfunction and sleep apnea has been confirmed from multiple facets. Patients with obstructive sleep apnea (OSA) showed a significant delay in the onset of the swallowing reflex compared to the healthy controls. Pathological evaluations revealed neuronal injuries of the pharynx in patients with OSA. Furthermore, the coordination between respiration and swallowing was impaired in patients with OSA. OSA also worsened the gastroesophageal reflux disease, which can be a risk factor for aspiration. Finally, patients with OSA were frequently complicated with other comorbidities including cerebrovascular diseases. Possibly owing to these deficits, some investigations had revealed a significant association between sleep apnea and the development of pneumonia. Dysphagia induced by OSA was reversible with the continuous positive airway pressure (CPAP) therapy. In addition, OSA was a major risk factor for the poor prognosis and frequent exacerbations of chronic obstructive pulmonary diseases, and the CPAP therapy proved effective in preventing these harmful effects. Administration of benzodiazepines or benzodiazepine-related drugs was also significantly associated with the development of pneumonia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Teramoto S, Sudo E, Matsuse T, Ohga E, Ishii T, Ouchi Y, Fukuchi Y. Impaired swallowing reflex in patients with obstructive sleep apnea syndrome. Chest. 1999;116:17–21.

    Article  CAS  Google Scholar 

  2. Leopold NA, Kagel MC. Dysphagia--ingestion or deglutition?: a proposed paradigm. Dysphagia. 1997;12:202–6.

    Article  CAS  Google Scholar 

  3. Budhiraja R, Budhiraja P, Quan SF. Sleep-disordered breathing and cardiovascular disorders. Respir Care. 2010;55:1322–32. Discussion 1330–2

    PubMed  PubMed Central  Google Scholar 

  4. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046–53.

    Article  Google Scholar 

  5. Nguyen AT, Jobin V, Payne R, Beauregard J, Naor N, Kimoff RJ. Laryngeal and velopharyngeal sensory impairment in obstructive sleep apnea. Sleep. 2005;28:585–93.

    Article  Google Scholar 

  6. Ghannouchi I, Speyer R, Doma K, Cordier R, Verin E. Swallowing function and chronic respiratory diseases: systematic review. Respir Med. 2016;117:54–64. https://doi.org/10.1016/j.rmed.2016.05.024.

    Article  PubMed  Google Scholar 

  7. Teramoto S, Ishii T, Matsuse T. Relationship between swallowing function and gas exchange during day and night in patients with obstructive sleep apnea syndrome. Dysphagia. 2001;16:249–53.

    Article  CAS  Google Scholar 

  8. Jäghagen EL, Berggren D, Isberg A. Swallowing dysfunction related to snoring: a videoradiographic study. Acta Otolaryngol. 2000;120:438–43.

    Article  Google Scholar 

  9. Shah F, Holmlund T, Levring Jäghagen E, Berggren D, Franklin K, Forsgren S, Stål P. Axon and Schwann cell degeneration in nerves of upper airway relates to pharyngeal dysfunction in snorers and patients with sleep apnea. Chest. 2018;154:1091–8. https://doi.org/10.1016/j.chest.2018.06.017.

    Article  PubMed  Google Scholar 

  10. Okada S, Ouchi Y, Teramoto S. Nasal continuous positive airway pressure and weight loss improve swallowing reflex in patients with obstructive sleep apnea syndrome. Respiration. 2000;67:464–6.

    Article  CAS  Google Scholar 

  11. Kimoff RJ, Sforza E, Champagne V, Ofiara L, Gendron D. Upper airway sensation in snoring and obstructive sleep apnea. Am J Respir Crit Care Med. 2001;164:250–5.

    Article  CAS  Google Scholar 

  12. Caparroz FA, de Almeida Torres Campanholo M, Sguillar DA, Haddad L, Park SW, Bittencourt L, Tufik S, FLM H. A pilot study on the efficacy of continuous positive airway pressure on the manifestations of dysphagia in patients with obstructive sleep apnea. Dysphagia. 2019;34:333–40. https://doi.org/10.1007/s00455-018-9944-1.

    Article  PubMed  Google Scholar 

  13. Gross RD, Atwood CW Jr, Ross SB, Olszewski JW, Eichhorn KA. The coordination of breathing and swallowing in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009;179:559–65. https://doi.org/10.1164/rccm.200807-1139OC.

    Article  PubMed  Google Scholar 

  14. Troche MS, Huebner I, Rosenbek JC, Okun MS, Sapienza CM. Respiratory-swallowing coordination and swallowing safety in patients with Parkinson's disease. Dysphagia. 2011;26:218–24. https://doi.org/10.1007/s00455-010-9289-x.

    Article  PubMed  Google Scholar 

  15. Sato K, Nakashima T. Sleep-related deglutition in patients with sleep apnea-hypopnea syndrome. Ann Otol Rhinol Laryngol. 2009;118:30–6.

    Article  Google Scholar 

  16. Sato K, Umeno H, Chitose S, Nakashima T. Sleep-related deglutition in patients with OSAHS under CPAP therapy. Acta Otolaryngol. 2011;131:181–9. https://doi.org/10.3109/00016489.2010.520166.

    Article  PubMed  Google Scholar 

  17. Wu ZH, Yang XP, Niu X, Xiao XY, Chen X. The relationship between obstructive sleep apnea hypopnea syndrome and gastroesophageal reflux disease: a meta-analysis. Sleep Breath. 2019;23:389–97. https://doi.org/10.1007/s11325-018-1691-x.

    Article  PubMed  Google Scholar 

  18. Ishii M, Yamaguchi Y, Yamamoto H, Ouchi Y, Osumi S, Nakamura T. Relationship between sleep apnea and respiratory infections in bedridden elderly individuals on tube feeding. J Am Geriatr Soc. 2012;60:790–2. https://doi.org/10.1111/j.1532-5415.2011.03874.x.

    Article  PubMed  Google Scholar 

  19. Morimoto S, Takahashi T, Okaishi K, Okuro M, Nakahashi T, Sakamoto D, et al. Sleep apnoea syndrome as a risk for mortality in elderly inpatients. J Int Med Res. 2012;40:601–11.

    Article  CAS  Google Scholar 

  20. Su VY, Liu CJ, Wang HK, Wu LA, Chang SC, Perng DW, et al. Sleep apnea and risk of pneumonia: a nationwide population-based study. CMAJ. 2014;186:415–21. https://doi.org/10.1503/cmaj.131547.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Chiner E, Llombart M, Valls J, Pastor E, Sancho-Chust JN, Andreu AL, Sánchez-de-la-Torre M, Barbé F. Association between obstructive sleep apnea and community-acquired pneumonia. PLoS One. 2016;11:e0152749. https://doi.org/10.1371/journal.pone.0152749.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Marin JM, Soriano JB, Carrizo SJ, Boldova A, Celli BR. Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med. 2010;182:325–31. https://doi.org/10.1164/rccm.200912-1869OC.

    Article  PubMed  Google Scholar 

  23. Mermigkis C, Bouloukaki I, Schiza SE. Sleep as a new target for improving outcomes in idiopathic pulmonary fibrosis. Chest. 2017;152:1327–38. https://doi.org/10.1016/j.chest.2017.07.019.

    Article  PubMed  Google Scholar 

  24. Davies SE, Bishopp A, Wharton S, Turner AM, Mansur AH. The association between asthma and obstructive sleep apnea (OSA): a systematic review. J Asthma. 2019 Feb;56(2):118–29. https://doi.org/10.1080/02770903.2018.1444049.

    Article  PubMed  Google Scholar 

  25. Teramoto S. A possible pathological link among swallowing dysfunction, gastro-esophageal reflex, and sleep apnea in acute exacerbation in COPD patients. Int J Chron Obstruct Pulmon Dis. 2016;11:147–50. https://doi.org/10.2147/COPD.S99663.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Maeda T, Babazono A, Nishi T, Yasui M. Quantification of adverse effects of regular use of triazolam on clinical outcomes for older people with insomnia: a retrospective cohort study. Int J Geriatr Psychiatry. 2016;31:186–94. https://doi.org/10.1002/gps.4310.

    Article  PubMed  Google Scholar 

  27. Sun GQ, Zhang L, Zhang LN, Wu Z, Hu DF. Benzodiazepines or related drugs and risk of pneumonia: a systematic review and meta-analysis. Int J Geriatr Psychiatry. 2019;34:513–21. https://doi.org/10.1002/gps.5048.

    Article  PubMed  Google Scholar 

  28. Lin SM, Yang SH, Liang CC, Huang HK, Loh CH. Association between benzodiazepine use and risks of chronic-onset poststroke pneumonia: a population-based cohort study. BMJ Open. 2019;9:e024180. https://doi.org/10.1136/bmjopen-2018-024180.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Taipale H, Tolppanen AM, Koponen M, Tanskanen A, Lavikainen P, Sund R, Tiihonen J, Hartikainen S. Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease. CMAJ. 2017;189:E519–29. https://doi.org/10.1503/cmaj.160126.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Joya FL, Kripke DF, Loving RT, Dawson A, Kline LE. Meta-analyses of hypnotics and infections: eszopiclone, ramelteon, zaleplon, and zolpidem. J Clin Sleep Med. 2009;5:377–83.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of respiratory medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Yasuhiro Yamaguchi

Authors
  1. Yasuhiro Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasuhiro Yamaguchi .

Editor information

Editors and Affiliations

  1. Department of Respiratory Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan

    Shinji Teramoto

  2. Respiratory Medicine & Infectious Diseases, Oita University Faculty of Medicine, Yufu, Oita, Japan

    Kosaku Komiya

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Yamaguchi, Y. (2020). Sleep Apnea, Hypnotics, and Aspiration Pneumonia: Is There Any Association Between Sleep Apnea and Aspiration Pneumonia?. In: Teramoto, S., Komiya, K. (eds) Aspiration Pneumonia. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-15-4506-1_22

Download citation

  • DOI: https://doi.org/10.1007/978-981-15-4506-1_22

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-4505-4

  • Online ISBN: 978-981-15-4506-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation