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Speech Therapy Performance in OSAS Patients and the Contribution to CPAP Beginners Use
A person with OSAS obstructive Sleep Apnea Syndrome usually comes to the office complaining of snoring, choking and frequent waking up with breathlessness and excessive tiredness during the day. And we know that most patients who are referred for CPAP ContinuousPositiveAirwayPressure use have poor performance and adherence. Speech therapy is necessary to adapt the breathing posture training for the physiological and functional strengthening of organs of the oro pharyngeal region and speech therapy intervention in mouth breathing syndrome and temporomandibular disorders which influence the use of CPAP. The speech therapy work was essential to the success of the treatment.
The adequate therapeutic effect on OSAS and adherence to CPAP use,was the objective in this case study.
60 year old patient; BMI:23,2; Women. Complaint:Frequent headaches; strong snores; daytime tiredness. Speech Therapy exercises for the adaptation of aero-dynamic forces; myofunctional exercises; nasal breathing training using nasal mask and CPAP therapy to adjust pressure level in 7-10cmH2O was defined on titration polysomnography and is the pressure needed to supply sleep apnea. Monitoring the results of CPAP use for 30 days; 3 months and 6 months.The patient was instructed to maintain the same spontaneous breathing rhythm avoiding trying to follow the CPAP rhythm.Relaxation and the use of habitual breathing reassures the patient and avoids discomfort and shortness of breath.
Already after the 10 sessions of speech therapy, she was able to use CPAP. Comparing the exam rates we have: Polysomnography1:AHI:58,5 events per hour; Polysomnography2 with CPAP: AHI: 16,2 events per hour; Treatment Compliance Report 90 days:AHI:1,1 events per hour.Guidelines on sleep hygiene + CPAP use was important to get positive results to snoring. During the treatment the patient showed satisfaction with the results.
Comparing the polysomnography exams it can be seen that the apnea and hypopnea index using CPAP decreases but still maintains a moderate level change in AHI16,2 events per hour. Concluding that through speech therapy sleep monitoring we achieved treatment sucess as found in the treatment compliance report demonstrating an AHI 1,1 events per hour. Effective treatment and adherence to CPAP requires myofunctional therapy follow-up and monitoring. The adaptation to CPAP and the fall in apnea and hipopnea events return the patient to health and disposition daily.
apnea; snoring; cpap therapy; sleep therapy
Relato de Caso
Juliana Pádua Blank