The Effect of Bilevel Positive Airway Pressure on Voice Quality

Abstract

Inflammation of the upper airways, thickening of the lateral pharyngeal walls, elongation of the soft palate and uvula, hypertrophy of the tonsils and base of the tongue can be seen in obstructive sleep apnea syndrome patients. Changes in these structures may affect articulation and phonation, negatively affecting the quality of the voice. Positive airway pressure (PAP) treatment reduces the volume of the root of the tongue, dissolves the edema in the upper respiratory tract, increases the posterior pharyngeal area, and positively changes the quality of the voice. A total of 151 people, 50 control group, and 101 patients, were included in the study between December 2020 and December 2021. The patient group was divided into two groups as continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP) users. All voice recordings were made in the control group and the patient group before and 3 months after CPAP and BPAP treatment, and were evaluated with the Praat (Paul, 2001) voice analysis program. The fundamental frequency of the sound (F0), frequency perturbation (jitter), amplitude perturbation (shimmer), noise-to-harmonic ratio (NHR) values were evaluated in the patient and control groups, and they were compared with each other before and after the treatment in the CPAP and BPAP groups. Before and after PAP treatment; the changes in F0, Jitter, Shimmer, and NHR in the CPAP and BPAP group were statistically significant (P < 0.05). While the F0 change before and after PAP treatment was the most in the CPAP group, the jitter, shimmer and NHR changes were the most in the BPAP group. Regular 3-month PAP treatment positively affects F0, jitter, shimmer and NHR values. The greatest F0 change is in the use of CPAP, the improvement in jitter, shimmer and NHR is the most in the use of BPAP.