الفهرس 
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Abstract
There is no study evaluated the relation of the APA and OSA severity in Arabic-speaking patients. So, the aim of this study was to develop an APA scale that include respiration, phonation, resonance, articulation and prosody evaluation among Arabic-speaking OSA patients. Also, to investigate the acoustic properties of speech and voice in obstructive sleep apnea patients and their relation to the APA of such patients. The present study was conducted on 69 OSA patients with age range from 22 to 68 years old, attended to sleep related breathing disorders clinic at Mansoura University Hospitals, diagnosed by full night attended laboratory Polysomnography. The patients were classified into three groups according to severity, group I included 12 patients with mild OSA, group II included 18 patients with moderate OSA and group III included 39 patients with severe OSA. All patients were subjected to the following protocol of assessment at Phoniatric unit [Vocal tract examination, auditory perceptual assessment, awake fibroptic nasoendoscopy with MM, acoustic analysis of (voice) by Praat and of (speech) by nasometry. Vocal tract examination (Friedman tongue position) showed highly significant increase in score with the increase of severity of OSA. All items of APA were assessed and showed the difference among the three groups. Respiration showed no statistically significant difference between the three groups but labored and uncoordinated breathing were more in severe group. About 33.4% of cases have dysphonia grade I or II with decrease pitch or loudness but there were no statistically significant differences among the three groups, however, the voice was most affected in severe OSA group. Items of APA including (dysphonia, loudness and pitch), were positively correlated with items of acoustic analysis (jitter & shimmer and HNR). Closed nasality was more detected in mild & moderate groups, while in severe OSA cul de sac resonance was more. There was statistically significant positive association between APA of resonance items and acoustic analysis of speech (total score of oral sentences &nasal sentences). Awake fibroptic nasoendoscopy with MM was done for all studied groups for its predictive value of the severity of OSA diagnosis, the results revealed that there was significant difference among the three groups regarding grade of collapse, the coronal shape was most frequent shape of collapse. There was no association between APA of resonance and degree of collapse regarding the three levels (retro palatal, retro glossal and hypo pharyngeal).