Voz, refluxo gastroesofágico, disfagia e qualidade de vida relacionados à apneia obstrutiva do sono

Abstract

Obstructive Sleep Apnea (OSA) is a common characteristic symptom that occurs during sleep, characterized by repetitive partial (hypopnea) or complete (apnea) collapse of the upper airway. It can cause sleep fragmentation, hypoxemia and result in excessive daytime sleepiness, also being associated with increased mortality. Also, an OSA can cause negative effects on the voice, which is the main tool for communication in daily life, directly affecting the quality of life of patients. The aim of this study was to verify the prevalence of fatigue and vocals, gastroesophageal symptoms, risk of dysphagia and sleep-related quality of life (symptoms) in individuals with OSA treated with CPAP, apneic individuals without treatment and in non-apneic individuals. A cross-sectional, quantitative and prospective study was carried out, in which participants who previously underwent the polysomnography examination at a Sleep Clinic, at the Physiology and Rehabilitation Laboratory and at the Sleep Laboratory of the University Hospital of Santa Maria, as well as patients being monitored by a physiotherapist, they were invited to respond to an online advice on vocal, gastroesophageal, dysphagia and quality of life aspects related to sleep in OSA. The sample consisted of 67 people, divided into three groups: OSA undergoing CPAP treatment (n= 29); untreated OSA (n=25); and control group with patients who did not have OSA (n= 13). The online questions contained questions regarding personal and sociodemographic data, history of physical activity, alcohol consumption, history of COVID-19, presence of gastroesophageal reflux symptoms, risk of dysphagia (EAT-10), sleep-related quality of life (QSQ), vocal fatigue (VFI) and voice handicap (VHI). The nonparametric Kolmogorov-Smirnov test was used to analyze the normal distribution of quantitative data and the Equality of Two Proportions test for qualitative parameters. Differences between groups were continuous using the Kruskal-Wallis test and to determine which groups the difference occurred using the Mann-Whitney test. Spearman's correlation test was used to analyze CPAP parameters and OSA severity with the following variables: sleep quality of life, VHI, VFI and risk of dysphagia. For statistical significance, a value of p<0.05 was considered. The OSA group with CPAP showed a statistically significant difference regarding the QSQ and psychological symptoms in the VHI, there was a statistically significant difference when comparing the OSA group without treatment and the group OSA with CPAP, OSA with CPAP showed less handicap of voice. Comparing the groups in relation to vocal fatigue and the risk of dysphagia, there was no statistically significant difference. The OSA and CPAP group had better quality of life and lower selfperception of voice symptons in the functional domain compared to individuals with untreated OSA. Regarding the symptoms of vocal fatigue and the risk of dysphagia, the groups did not differ. The apnea- hypopnea index did not present correlation with the self-perceived symptoms of voice and quality of life. CPAP treatment improves quality of life and improves self-perception of vocal advantage.