A simple procedure for measuring pharyngeal sensitivity: a contribution to the diagnosis of sleep apnoea

Dematteis, M.; LéVy, P.; Pépin, J-L
May 2005
Thorax;May2005, Vol. 60 Issue 5, p418
Academic Journal
Background: Patients with severe apnoea may have an impaired pharyngeal dilating reflex related to decreased pharyngeal sensitivity. The accuracy of a simple new procedure to measure pharyngeal sensitivity and to diagnose sleep disordered breathing (5DB) was investigated. Methods: Pharyngeal disappearance and appearance sensory perception thresholds were measured by delivering different airflow rates on the soft palate using an intraoral device in 17 controls and 50 patients suffering from 5DB evaluated by overnight polygraphy. The procedure was performed before (baseline) and after three successive administrations of a topical anaesthetic to sensitise the pharyngeal sensory impairment. Pharyngeal sensitivity was then evaluated according to 5DB severity. 5DB was classified as mild, moderate or severe according to the relative proportion of obstructive apnoeas-hypopnoeas and the amount of desaturation. Results: Patients had higher baseline disappearance and appearance sensory thresholds than controls (mean (SD) 0.62 (0.44) vO.26 (0.06) 1/mm and 0.85(0.40) vO.40 (0.19) 1/mm, pcO.OOI, respectively). Such differences were enhanced by topical anaesthesia. Impairment of pharyngeal sensitivity and the number of patients with impaired sensitivity increased from the least to the most severe 5DB group as indicated by the test sensitivity for a respiratory disturbance index of >20/hour (50%, 73.7% and 88.5% in the mild, moderate, and severely affected groups, respectively). Conclusions: This simple and safe procedure showed that impairment of pharyngeal sensitivity is correlated with severity of 5DB. Using this test in routine clinical practice may simplify the diagnosis of sleep apnoea, particularly for the most severe patients.


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