Breathing pattern during sequential swallowing in healthy adult humans

Abstract

Sequential liquid swallowing is a common daily occurrence during which coordination of deglutition and breathing are highly regulated to avoid pulmonary aspiration and to maintain hematosis. We studied the effects of sequential water swallowing (SWS) at fixed swallowing rates and with regular succession of swallows on respiration in healthy subjects. Thirty-one normal adults (19 men, 12 women) with a mean age of 27.96 3.68 yr were explored at rest and during SWS (at 12 and 24 swallows/min). Respiration was recorded by intranasal air pressure changes and timing of deglutition by an acoustic method. Oxygen saturation [arterial O 2 saturation from pulse oximetry (Sp O2 )] was monitored with a finger probe. During SWS, we determined the respiratory phase (inspiration or expiration) before and after each ingestion cycle (IC; period of sustained apnea including 1 or more swallows). We also measured inspiratory time (TI), expiratory time (TE), respiratory cycle duration (TT), respiratory rate (RR) and Sp O2 at rest and during SWS. We showed that respiration was interrupted by sequential swallows determining a succession of ICs that were often preceded and followed by expiration. During SWS, TI decreased and TE increased compared with rest (P 0.01). However, TT, RR, and Sp O2 did not change. It seems that the preferential coupling of swallowing with expiration during SWS is favored by an increase in TE to ensure airway protection, although the repetitive swallows, RR, and Sp O2 were not altered during SWS. These data may be useful to study the effects of aging and pathological conditions on swallowing and breathing coordination during SWS.