Vocal changes in patients using nasal continuous positive airway pressure

Area of Science:

• Otolaryngology
• Speech and Language Pathology
• Pulmonology

Background:

• Continuous Positive Airway Pressure (CPAP) is a common treatment for sleep apnea.
• Vocal changes can impact quality of life and treatment adherence.
• The effects of nasal CPAP on voice production are not fully understood.

Purpose of the Study:

• To prospectively evaluate vocal changes in patients using nasal CPAP.
• To compare voice parameters between nasal CPAP users and a matched control group.
• To investigate potential mechanisms behind CPAP-induced vocal alterations.

Main Methods:

• Prospective study design with 18 nasal CPAP users and a matched control group.
• Perceptual voice assessment using a hoarseness grading scale (G0-G3).
• Objective acoustic analysis measuring fundamental frequency, habitual pitch, shimmer, relative average perturbation, voice turbulence index, and noise-to-harmonic ratio.

Main Results:

• Statistically significant differences in perceptual voice evaluation between groups, with more CPAP users experiencing moderate hoarseness.
• Increased perturbation parameters (shimmer, relative average perturbation) in the CPAP group.
• Decreased fundamental frequency and habitual pitch in the CPAP group compared to controls, with a significant increase in shimmer.

Conclusions:

• Nasal CPAP usage appears to induce mild to moderate hoarseness and increased voice perturbation.
• These vocal changes are potentially secondary to upper airway dryness associated with CPAP therapy.
• The study discusses the hypothetical impact of nasal CPAP on the vocal fold's sol layer, suggesting a need for further investigation.