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EFFECT OF SEMI-OCCLUDED VOCAL TRACT EXERCISES ON OBSTRUCTIVE SLEEP APNEA
Orofacial Myofunctional Therapy (OMT), a speech therapy resource, is an alternative treatment of obstructive sleep apnea (OSA). OMT are exercises that aim modifying orofacial muscle and functional patterns. Among the techniques are the semi-occluded vocal tract exercises (SOTVS), especially the exercise of voiced blowing, which increases the muscle tone of the structures of the upper airways and the space of the oral and pharyngeal cavity, bnefitial in OSA.
To evaluate the effects of SOTVS exercises in OSA patients.
Report of two female OSA patients, one diagnosed mild OSA, apnea/hypopnea index (AHI 5.4), body mass index (BMI) 26.3 kg/m2, the second one moderate (AHI 26) and BMI 22.9 kg/m2; aged 56 and 65 years, respectively. After anamnesis, including the sleep questionnaires (Epworth Sleepiness Scale, Pittsburg Sleep Quality Index-PSQI and Berlin Questionnaire-BQ), and the speech therapy evaluation (OMES-E and GRBASI protocol), both were submitted to speech therapy, based on the exercise of voiced blowing, in a silicone tube for 20 minutes daily, during 10 week period, as the only therapeutic resource. The individuals were reassessed after, repeating all the protocols.
The first patient presented changes in posture, mobility, and tonus of orofacial structures (OMES-E=84), reduced nasal airflow, an unaltered voice quality (GRBASI=0), a reduced sleep quality (PSQI =16), and intense snoring (BQ=8). After 10 weeks of SOTVS we observed BMI preservation, improving of posture, mobility, and tonus of oropharyngeal structures (OMES-E=91), nasal airflow, as well as subjective sleep parameters of snoring (BQ=6) and sleep quality (PSQI=8). The second patient, initially presented changes in posture, mobility, and tonus of the orofacial structures (OMES-E=86), mild vocal alteration (GRBASI 1), reduced sleep quality (PSQI=21), and intense snoring (BQ=8). At the reassessment, even if the BMI increased (25.7), an improvement was verified in the posture, mobility, and tonus of the orofacial structures (OMES-E=93), vocal quality without alteration (GRBASI=0), increase in sleep quality (PSQI=16), and reduction of snoring (BQ=6).
The findings suggest the feasibility of using SOTVS exercises as a therapeutic resource in OMT for OSA. However, further research is needed involving a larger number of participants, as well as objective tests to control the clinical evolution.
Speech Therapy, Obstructive sleep apnea, Treatment, Voice Training
Relato de Caso
DANIELLE BARRETO e SILVA, JÉSSICA BRUNA MAGALHÃES MELGAÇO, LOUISE CAVALIN DA SILVA, VANESSA DE JESUS MOREIRA, CAMILA DE CASTRO CORRÊA, CARINE PETRY, Silke Anna Theresa Weber