My Research Tuesday contribution this month is the first in a two part series regarding Obstructive Sleep Apnea. Part two will be posted in June 2014. It will detail my application of methods outlined in a related study, Guimaraes et al. 2009.
There are a number of alternatives for the treatment of obstructive sleep apnea (OSA). I have never personally known of Speech-Language Pathologists (SLPs) being included as members of the OSA treatment team. Continuous Positive Airway Pressure (CPAP) is generally considered the gold standard therapeutic modality; however, research shows that more than 50% of subjects enrolled in CPAP therapy become non-compliant for a variety of factors. (See references on the Neirman Practice Management website.) Discomfort, aesthetics, and aggravation of pre-existing asthma are a few of the reasons cited for discontinuing therapy following polysomnography and fitting of the device.
My May 2014 blog for Research Tuesday compares changes in perceived quality of life following treatment with CPAP, Speech Therapy, Combination Speech Therapy/CPAP, or Placebo/sham ST (P/sST) services for OSA
Diaferia G, Badke L, Santos-Silva R, et al 2013. Effect of speech therapy as adjunct treatment to continuous positive airway pressure on the quality of life of patients with obstructive sleep apnea. Sleep Medicine 2013;14: 628-635.
A group of Brazilian researchers conducted a randomized study of 100 men with OSA. Their aim was to determine the impact of Speech Therapy (ST) , with and without the use of CPAP therapy, on subject condition and quality of life (QoL) in particular.
Participants enrolled in a three month treatment protocol. They were randomly assigned to one of the following four groups:
Placebo/Sham Speech Therapy (PsST): 24
Speech Therapy (ST): 27
CPAP Only (CPAP): 27
Combination Speech Therapy/CPAP (Combination): 22
Pre-treatment and post-treatment objective and perceptual measures were conducted.
The researchers found that QoL and Apnea Hypopnia Index (AHI) scores improved for participants in the CPAP, Combination, and ST groups. The CPAP and Combination therapy groups also demonstrated improvement in arousal index scores, and the group enrolled in ST alone presented with improved AHI compared to the P/sST group. It is also interesting that upon conclusion of the study the combination group demonstrated longer periods of CPAP utilization than participants in the CPAP only group.
The results of this study add support to the concept of utilizing OPEs familiar to Speech-Language Pathologists as a viable treatment alternative for OSA. Please watch for my June 2014 Research Tuesday blog. It will detail an informal clinical trial I based upon the Guimaraes et al. 2009 study cited and referenced herein.
Guimaraes KC, Drager LF, Genta PR, Marcondes BF, Lorenzi-Fillho, G. Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2009; 179:962-6
On the Web: Neirman Practice Management, Snoring Isn’t Sexy access 5/13/2014 at http://www.snoringisntsexy.com/cpap-mask-problems.cfm.
Cyndee Williams Bowen, MS, CCC-SLP owns Bowen Speech-Language Therapy, LLC in Clearwater, FL. She is committed to empowering her clients to find their best voice, swallow safely, and achieve an improved quality of life. Visit the Bowen Speech Website for more information.