Mapping multidimensional voice assessment procedures and results in individuals with sleep-related breathing disorder: A scoping review


Objective: map the procedures and characterize the results obtained in the multidimensional assessment of the voice of individuals with sleep-related breathing disorders. Methods: This is a scoping review (ScR), whose protocol was registered in the Open Science Framework (doi 1017605/OSF.IO/2QRMY). It followed the methodology of the Joanna Briggs Institute and was described according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The methodology was grounded on the PCC strategy: Participants: Individuals with sleep-disordered breathing; Concept: Multidimensional voice assessment procedures and their results; and, Context: Voice clinics. This ScR had the following research questions: “What multidimensional voice assessment procedures are used in individuals with sleep-disordered breathing who seek voice clinics? What results are obtained from multidimensional voice assessment of individuals with sleep-disordered breathing?”. The electronic search was conducted in the databases PUBMED, LILACS, SCOPUS, EMBASE, Web of Science, and Cochrane, as well as in the gray literature via ProQuest, MedRxiv, and Google Scholar. Manual search was performed by screening citations and consulting experts. A search strategy was developed for each source of evidence. The search, selection, and data extraction were conducted independently by two calibrated reviewers, with disagreements resolved by consensus. The results were presented descriptively. Results: The search found 1,089 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; Voice Handicap Index-10 (VHI-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.

Mara
Fernanda
Mayra
Bruna
Vanessa
Behlau
Brasileiro
Ayupe
Rainho Rocha
Veis Ribeiro