Mapping Voice Assessment Procedures and Results in Individuals with Sleep-Related Breathing Disorder: A Scoping Review.

Objective: To map the procedures and characterize the results of multidimensional voice assessment of individuals with sleep-related breathing disorders.

Method: This scoping review searched the MEDLINE, LILACS, Scopus, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, ProQuest, and MedRxiv databases, manually searched citations, grey literature, and consulted with experts. It included studies whose participants had sleep-related breathing disorders and underwent voice assessment. Two calibrated reviewers independently searched, selected, and extracted data on publication, sample, and assessment; disagreements were resolved by consensus. The data were analyzed descriptively.

Results: The search found 1089 studies, of which 32 were selected. The sample comprised one study on catathrenia and 31 on obstructive sleep apnea. Acoustic analysis was the most used voice assessment procedure for sleep-related breathing disorders. The most frequent measures and instruments were jitter and fundamental frequency in acoustic analysis; maximum phonation time in aerodynamic assessment; GRBAS in auditory-perceptual judgment; Vocal Handicap Index-10 in vocal self-assessment; and videolaryngostroboscopy in laryngeal imaging. Shimmer and jitter were the measures most used to distinguish individuals with and without sleep-related breathing disorders and most verified as abnormal in individuals affected by such conditions.

Conclusion: Obstructive sleep apnea is the most studied sleep-related breathing disorder in the voice clinic. Acoustic analysis was the most used method to assess sleep-related breathing disorders, with disturbance measures being the most altered, and the most used to differentiate individuals with and without sleep-related breathing disorders.