Skip to main content
SpringerLink
Log in

The effect of obstructive sleep apnea syndrome and continuous positive airway pressure treatment on voice performance

  • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Objective

Obstructive sleep apnea syndrome (OSAS) may affect voice performance due to alterations that occur in the upper respiratory tract. The aim of the study was to assess the effect of OSAS and continuous positive airway pressure (CPAP) treatment on voice performance.

Materials and methods

Twenty-seven patients with moderate to severe OSAS (apnea-hypopnea index ≥15/h) who underwent polysomnographic examination and 28 age- and gender-matched normal control subjects were enrolled in the study. The patients and the control subjects completed Voice Handicap Index (VHI) questionnaires, and their acoustic voice analyses were performed. Fundamental frequency (F0), jitter %, and shimmer % parameters were statistically compared. Acoustic analyses were performed again 1 month after regular CPAP use in OSAS patients, and the parameters before and after the treatment were compared.

Results

F0 was 160.82 Hz, jitter was 0.70 %, shimmer was 1.05 %, and VHI was 1.18 in the control group. In OSAS patients before CPAP treatment, F0 was 157.04 Hz, jitter was 0.82 %, shimmer was 1.33 %, and VHI was 13.11. These results showed that shimmer and VHI parameters were significantly worse in OSAS patients. After CPAP treatment, F0 was 169.19 Hz, jitter was 0.62 %, shimmer was 0.93 % and VHI was 5.00. The differences were statistically significant in all parameters.

Conclusion

The acoustic parameters of OSAS patients differed from those of the normal control subjects. The patients’ voice performance improved after a regular use of CPAP treatment for 1 month.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK et al (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8:597–619

    PubMed Central  PubMed  Google Scholar 

  2. Köktürk O, Tatlicioglu T, Kemaloğlu Y, Fırat H, Çetin N (1997) Habituel horlaması olan olgularda obstrüktif sleep apne sendromu prevelansı. Tüberkülöz ve Toraks Dergisi 45:7–11

    Google Scholar 

  3. Han D, Xu W, Hu R, Zhang L (2012) Voice function following Han’s uvulopalatopharyngoplasty. J Laryngol Otol 126:47–51

    Article  CAS  PubMed  Google Scholar 

  4. Behrman A, Shikowitz MJ, Dailey S (2002) The effect of upper airway surgery on voice. Otolaryngol Head Neck Surg 127:36–42

    Article  PubMed  Google Scholar 

  5. Grote L, Hedner J, Peter JH (2000) Sleep-related breathing disorder is an independent risk factor for uncontrolled hypertension. J Hypertens 18:679–685

    Article  CAS  PubMed  Google Scholar 

  6. Ryan CF, Lowe AA, Li D, Fleetham JA (1991) Magnetic resonance imaging of the upper airway in obstructive sleep apnea before and after chronic nasal continuous positive airway pressure therapy. Am Rev Respir Dis 144:939–944

    Article  CAS  PubMed  Google Scholar 

  7. Shrivastava D (2014) Impact of sleep-disordered breathing treatment on upper airway anatomy and physiology. Sleep Med 15:733–741

    Article  PubMed  Google Scholar 

  8. Berry RB, Brooks R, Gamaldo CE, Harding SM, Lloyd RM, Marcus CL, Vaughn BV, for the American Academy of Sleep Medicine (2014) The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.0.3. www.aasmnet.org. Darien, Illinois, American Academy of Sleep Medicine

    Google Scholar 

  9. Baken RJ (1987) Clinical measurement of speech and voice. Allyn and Bacon, Needham Heights

    Google Scholar 

  10. Hirano M (1981) Clinical examination of voice. Springer, Vienna

    Google Scholar 

  11. Kılıç MA (2010) Evaluation of the patient with voice problem by objective and subjective methods. Curr Pract ORL 6:257–265

    Google Scholar 

  12. Morton LL, Diubaldo D (1993) Circadian differences in the dichotic processing of voicing. Int J Neurosci 68:43–52

    Article  CAS  PubMed  Google Scholar 

  13. Subramaniam V, Kumar P (2009) Impact of tonsillectomy with or without adenoidectomy on the acoustic parameters of the voice: a comparative study. Arch Otolaryngol Head Neck Surg 135:966–969

    Article  PubMed  Google Scholar 

  14. Kim YH, Lee SH, Park CW, Cho JH (2013) Nasalance change after sinonasal surgery: analysis of voice after septoturbinoplasty and endoscopic sinus surgery. Am J Rhinol Allergy 27:67–70

    Article  PubMed  Google Scholar 

  15. Dejonckere PH, Bradley P, Clemente P, Cornut G, Crevier-Buchman L, Friedrich G et al (2001) A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. Guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS). Eur Arch Otorhinolaryngol 258:77–82

    Article  CAS  PubMed  Google Scholar 

  16. Hogikyan ND, Sethuraman G (1999) Validation of an instrument to measure voice-related quality of life (V-RQOL). J Voice 13:557–569

    Article  CAS  PubMed  Google Scholar 

  17. Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS (1997) The voice handicap index (VHI): development and validation. Am J Speech Lang Pathol 6:66–70

    Article  Google Scholar 

  18. Hsiung MW, Pai L, Wang HW (2002) Correlation between voice handicap index and voice laboratory measurements in dysphonic patients. Eur Arch Otorhinolaryngol 259:97–99

    Article  CAS  PubMed  Google Scholar 

  19. Wheeler KM, Collins SP, Sapienza CM (2006) The relationship between VHI scores and specific acoustic measures of mildly disordered voice production. J Voice 20:308–317

    Article  PubMed  Google Scholar 

  20. Birkent H, Soken H, Akcam T, Karahatay S, Gerek M (2008) The effect of radiofrequency volumetric tissue reduction of soft palate on voice. Eur Arch Otorhinolaryngol 265:195–198

    Article  PubMed  Google Scholar 

  21. Van Lierde KM, Van Borsel J, Moerman M, Van Cauwenberge P (2002) Nasalance, nasality, voice, and articulation after uvulopalatopharyngoplasty. Laryngoscope 112:873–878

    Article  PubMed  Google Scholar 

  22. Greene JS, Zipfel TE, Harlor M (2004) The effect of uvulopalatopharyngoplasty on the nasality of voice. J Voice 18:423–430

    Article  PubMed  Google Scholar 

  23. Bertino G, Matti E, Migliazzi S, Pagella F, Tinelli C, Benazzo M (2006) Acoustic changes in voice after surgery for snoring: preliminary results. Acta Otorhinolaryngol Ital 26:110–114

    PubMed Central  CAS  PubMed  Google Scholar 

  24. Abu El-ella MY, Eldin HE, Malki KH, Samir MM, Abd Al-Naser NH, Mohamed AA (2010) Effect of classic uvulopalatopharyngoplasty and laser-assisted uvulopalatopharyngoplasty on voice acoustics and speech nasalance. Ann Saudi Med 230:459–463

    Google Scholar 

  25. Mora R, Jankowska B, Crippa B, Dellepiane M, Bavazzano M, Guastini L et al (2009) Effects of uvulopalatopharyngoplasty with Harmonic Scalpel on speech and voice. Eur Arch Otorhinolaryngol 266:1989–1994

    Article  PubMed  Google Scholar 

  26. Corda L, Redolfi S, Montemurro LT, La Piana GE, Bertella E, Tantucci C (2009) Short- and long-term effects of CPAP on upper airway anatomy and collapsibility in OSAH. Sleep Breath 13:187–193

    Article  PubMed  Google Scholar 

  27. Hamdan AL, Sabra O, Rifai H, Tabri D, Hussari A (2008) Vocal changes in patients using nasal continuous positive airway pressure. J Voice 22:603–606

    Article  PubMed  Google Scholar 

  28. Weaver TE, Maislin G, Dinges DF, Bloxham T, George CF, Greenberg H et al (2007) Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep 30:711–719

    PubMed Central  PubMed  Google Scholar 

  29. Engleman HM, Martin SE, Deary IJ, Douglas NJ (1994) Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Lancet 343:572–575

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Ankara Numune Education and Research Hospital, Ankara, Turkey

    Doğan Atan, Kürşat Murat Özcan, Aykut İkincioğulları, Sabri Köseoğlu, Mehmet Ali Çetin, Serdar Ensari & Hüseyin Dere

  2. Ankara Numune Eğitim ve Araştırma Hastanesi KBB kliniği, Samanpazarı, Ankara, Turkey

    Doğan Atan

Authors
  1. Doğan Atan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kürşat Murat Özcan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aykut İkincioğulları
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sabri Köseoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mehmet Ali Çetin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Serdar Ensari
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hüseyin Dere
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Doğan Atan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Atan, D., Özcan, K.M., İkincioğulları, A. et al. The effect of obstructive sleep apnea syndrome and continuous positive airway pressure treatment on voice performance. Sleep Breath 19, 777–782 (2015). https://doi.org/10.1007/s11325-014-1092-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-014-1092-8

Keywords

Search

Navigation