Download PDF
Open Access
CC BY-NC-ND 4.0 · Sleep Sci 2025; 18(04): e397-e403
DOI: 10.1055/s-0045-1813731
Original Article

Vocal and Orofacial Myofunctional Characteristics of Individuals with Obstructive Sleep Apnea

Authors

  • Melissa França Lima Martins

    1   Department of Neurosciences and Behavioral Sciences, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil

  • Alan Luiz Eckeli

    1   Department of Neurosciences and Behavioral Sciences, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil

  • Fernando Gustavo Stelzer

    1   Department of Neurosciences and Behavioral Sciences, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil

  • Fabiana Cardoso Pereira Valera

    2   Department of Ophthalmology, Otolaryngology, and Head and Neck Surgery, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil

  • Gislaine Aparecida Folha 

    3   Department of Health Sciences, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil

Funding This study was supported in part by the University of São Paulo - Protocol o. 11.1.21626.01.7.
Further Information
Also available at
  Permissions and Reprints

Abstract

Introduction

Obstructive sleep apnea (OSA) involves recurrent upper airway obstructions during sleep, leading to fragmentation and oxygen desaturation. Vocal complaints and orofacial myofunctional changes are common, but few studies assess both aspects in diagnosed patients.

Objective

To assess vocal parameters and orofacial myofunctional conditions in adults diagnosed with OSA, comparing them to a control group at low risk for OSA.

Methods

Cross-sectional study. A convenience sample (N = 63) was included: 33 with OSA confirmed by polysomnography and 30 controls at low risk for OSA (STOP-BANG < 3 and no reported snoring in Stanford Snoring Scale), aged between 18–60 years. Assessments included perceptual-auditory analysis of voice quality (GRBASI scale, Vocal Symptom Scale (VSS), maximum phonation time (MPT) for vowels and s/z ratio) and orofacial myofunctional evaluation (OMES-E protocol). Participants who had received previous treatment or medical conditions affecting OSA, voice or orofacial function were excluded.

Results

OSA group showed significantly higher scores on VSS and lower scores on OMES-E protocol. They also displayed shorter MPT, worse performance in s/z ratio, reduced pneumophonoarticulatory coordination, and higher frequency of vocal alterations. The OSA group revealed mean apnea-hypopnea index of 45.80, indicates predominance of severe cases, as well as increased desaturation index.

Conclusion

Individuals with OSA exhibit impairments in both orofacial myofunctional and vocal parameters, with negative alterations observed in MPT speech rate, pneumophonoarticulatory coordination, and s/z ratio compared with subjects with no OSA complaints. These findings highlight the importance of evaluating vocal and orofacial aspects together in OSA.

Keywords

snoring - obstructive sleep apnea - voice - orofacial motricity - sleep - evaluation study

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.


Author Contributions

Gislaine Aparecida Folha: conceptualization, methodology, investigation, writing – original draft preparation, review, and editing.

Melissa França Lima Martins: investigation, writing – review and editing.

Fernando Stelzer: formal analysis, writing – review and editing.

Fabiana Cardoso Pereira Valera: resources, review and editing.

Alan Luiz Eckeli: resources, methodology, formal analysis, writing – review and editing.




Publication History

Received: 05 May 2025

Accepted: 24 August 2025

Article published online:
31 December 2025

© 2025. Brazilian Sleep Academy. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil