Author(s)
Sharwani Kota, BS
Priya Mukhi, BS
Sandhya Ganesan, BS
Sana Smaoui, PhD
Affiliation(s)
George Washington University
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to describe the prevalence of dysphagia and diagnostic practice patterns in patients with obstructive sleep apnea (OSA) and discuss opportunities for multidisciplinary collaboration between otolaryngologists and speech-language pathologists to improve dysphagia care in this population.
Objectives: To assess the frequency of dysphagia diagnosis in patients with obstructive sleep apnea (OSA), characterize the use of clinical and instrumental swallowing evaluations, and identify gaps in care contributing to underdiagnosis of unsafe swallowing in this population.
Study Design: Retrospective database study.
Methods: A retrospective analysis was conducted using the TriNetX Research Network. Adult patients with OSA were identified using ICD-10 code G47.33. The prevalence of dysphagia (ICD-10 R13.1) and associated sequelae, including aspiration pneumonia (ICD-10 J69.0), were evaluated. Swallowing assessments were captured using CPT codes for clinical and instrumental evaluations (92610-92612).
Results: Of 4,758,345 patients with OSA, 7% had a documented diagnosis of dysphagia. The majority were coded with unspecified dysphagia (85%), followed by oropharyngeal dysphagia (20%). Aspiration pneumonia occurred in 8.51% of patients with both OSA and dysphagia. Despite this, only 16.87% of dysphagic patients underwent formal clinical or instrumental swallowing assessment. Specifically, 15.76% received a video fluoroscopic swallow study (VFSS) and 1.52% underwent flexible endoscopic evaluation of swallowing (FEES). Diagnostic yield varied by modality: 79.15% of patients undergoing instrumental evaluation were diagnosed with dysphagia, compared to 42.11% with clinical evaluation alone.
Conclusions: Dysphagia is underrecognized in patients with OSA, with most diagnoses made without formal assessment despite substantial aspiration risk. Instrumental evaluations significantly improve diagnostic accuracy but remain underutilized. These findings highlight the need for standardized, multidisciplinary screening protocols to improve the detection and management of dysphagia in the OSA population.