The higher risk of aspiration pneumonia among patients who have chronic obstructive pulmonary disease (COPD) may be caused by a dysfunctional breathing-swallowing pattern, researchers report. The problem is the during a COPD exacerbation, patients swallow food during inhalation, or inhale immediately after swallowing, which researchers say is opposite of normal patterns. Experts say this rhythm dysfunction may allow food to get into the upper airway, which could lead to aspiration pneumonia.