title: Effect of speech therapy as adjunct treatment to continuous positive airway pressure on the quality of life of patients with obstructive sleep apnea.
abstract: BACKGROUND
  Patients with obstructive sleep apnea (OSA) exhibit reduced quality of life (QoL) due to their daytime symptoms that restricted their social activities. The available data for QoL after treatment with continuous positive airway pressure (CPAP) are inconclusive, and few studies have assessed QoL after treatment with speech therapy or other methods that increase the tonus of the upper airway muscles or with a combination of these therapies. The aim of our study was to assess the effect of speech therapy alone or combined with CPAP on QoL in patients with OSA using three different questionnaires.
  
  
  METHODS
  Men with OSA were randomly allocated to four treatment groups: placebo, 24 patients had sham speech therapy; speech therapy, 27 patients had speech therapy; CPAP, 27 patients had treatment with CPAP; and combination, 22 patients had treatment with CPAP and speech therapy. All patients were treated for 3 months. Participants were assessed before and after treatment and after 3 weeks of a washout period using QoL questionnaires (Functional Outcomes of Sleep Questionnaire [FOSQ], World Health Organization Quality of Life [WHOQoL-Bref], and Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]). Additional testing measures included an excessive sleepiness scale (Epworth sleepiness scale [ESS]), polysomnography (PSG), and speech therapy assessment.
  
  
  RESULTS
  A total of 100 men aged 48.1±11.2 (mean±standard deviation) years had a body mass index (BMI) of 27.4±4.9 kg/m(2), an ESS score of 12.7±3.0, and apnea-hypopnea index (AHI) of 30.9±20.6. After treatment, speech therapy and combination groups showed improvement in the physical domain score of the WHOQoL-Bref and in the functional capacity domain score of the SF-36.
  
  
  CONCLUSIONS
  Our results suggest that speech therapy alone as well as in association with CPAP might be an alternative treatment for the improvement of QoL in patients with OSA.
authors.affiliation: Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Giovana
authors.initials: G
authors.lastname: Diaferia
authors.forename: Luciana
authors.initials: L
authors.lastname: Badke
authors.forename: Rogerio
authors.initials: R
authors.lastname: Santos-Silva
authors.forename: Silvana
authors.initials: S
authors.lastname: Bommarito
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
authors.forename: Lia
authors.initials: L
authors.lastname: Bittencourt
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D013070:Speech Therapy / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Continuous positive airway pressure; Obstructive sleep apnea; Polysomnography; Quality of life; Sleepiness; Speech therapy