Evaluation of the Relationship Between the Required Pressure Level in Continuous Positive Airway Pressure Treatment and Voice in Patients With Obstructive Sleep Apnea Syndrome

Abstract

The aim of this study was to investigate the effect of obstructive sleep apnea syndrome on voice, the relationship between the required pressure levels in continuous positive airway pressure (CPAP) and voice, and the effects of CPAP therapy on voice. A total of 73 subjects consisting of 53 patients and 20 control subjects were included in the study. The patient group was further divided into low- (Group A) and high- (Group B) pressure groups according to the required pressure level. All subjects underwent acoustic sound analysis to evaluate fundamental frequency (F0), jitter, shimmer, and noise-to-harmonics ratio (NHR). Acoustic voice analysis was repeated after 3 months of regular CPAP treatment in the patient group. The mean F0, jitter, shimmer, and NHR values of the patient group and control group were compared. Intergroup comparisons were also performed between Group A and the control group, and between Group B and the control group. Finally, before and after CPAP treatment values of mean F0, jitter, shimmer, and NHR were compared in Group A and Group B. The mean shimmer and NHR values of the patient group were significantly higher than the control group (P=0.01 and P=0.023, respectively). The mean shimmer and NHR values of Group B were statistically higher than the control group (P=0.002 and P < 0.001, respectively). The mean jitter, shimmer, and NHR values after CPAP treatment were significantly lower than those measured before CPAP treatment in Group B (P=0.003, P=0.001, and P=0.001, respectively). Voice is negatively affected in obstructive sleep apnea syndrome patients who require high pressure in CPAP treatment. CPAP treatment leads to improved voice in these patients.