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Swallowing Activity Assessed by Ambulatory Impedance-pH Monitoring Predicts Awake and Asleep Periods at Night

Pohl, D. ; Arevalo, F. ; Singh, E. ; Freeman, J. ; Tutuian, R. ; Castell, D.

In: Digestive Diseases and Sciences, 2013, vol. 58, no. 4, p. 1049-1053

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    Titre
    • Swallowing Activity Assessed by Ambulatory Impedance-pH Monitoring Predicts Awake and Asleep Periods at Night
    Auteur
    • Pohl, D.. Division of Gastroenterology and Hepatology, Digestive Disease Center, Medical University of South Carolina, Charleston, SC, USA
    • Arevalo, F.. Division of Gastroenterology and Hepatology, Digestive Disease Center, Medical University of South Carolina, Charleston, SC, USA
    • Singh, E.. Division of Gastroenterology and Hepatology, Digestive Disease Center, Medical University of South Carolina, Charleston, SC, USA
    • Freeman, J.. Division of Gastroenterology and Hepatology, Digestive Disease Center, Medical University of South Carolina, Charleston, SC, USA
    • Tutuian, R.. Division of Gastroenterology, University Clinics for Visceral Surgery and Medicine, Berne, Switzerland
    • Castell, D.. Division of Gastroenterology and Hepatology, Digestive Disease Center, Medical University of South Carolina, Charleston, SC, USA
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Digestive Diseases and Sciences, 2013, vol. 58, no. 4, p. 1049-1053. Springer US; http://www.springer-ny.com
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:320259
    Summary
    Introduction: Voluntary muscle activity, including swallowing, decreases during the night. The association between nocturnal awakenings and swallowing activity is under-researched with limited information on the frequency of swallows during awake and asleep periods. Aim: The aim of this study was to assess nocturnal swallowing activity and identify a cut-off predicting awake and asleep periods. Methods: Patients undergoing impedance-pH monitoring as part of GERD work-up were asked to wear a wrist activity detecting device (Actigraph®) at night. Swallowing activity was quantified by analysing impedance changes in the proximal esophagus. Awake and asleep periods were determined using a validated scoring system (Sadeh algorithm). Receiver operating characteristics (ROC) analyses were performed to determine sensitivity, specificity and accuracy of swallowing frequency to identify awake and asleep periods. Results: Data from 76 patients (28male, 48 female; mean age 56±15years) were included in the analysis. The ROC analysis found that 0.33sw/min (i.e. one swallow every 3min) had the optimal sensitivity (78%) and specificity (76%) to differentiate awake from asleep periods. A swallowing frequency of 0.25sw/min (i.e. one swallow every 4min) was 93% sensitive and 57% specific to identify awake periods. A swallowing frequency of 1sw/min was 20% sensitive but 96% specific in identifying awake periods. Summary and Conclusion: Impedance-pH monitoring detects differences in swallowing activity during awake and asleep periods. Swallowing frequency noticed during ambulatory impedance-pH monitoring can predict the state of consciousness during nocturnal periods