Experiences of Speaking With Noninvasive Positive Pressure Ventilation: A Qualitative Investigation

Authors

Deanna Britton, Portland State UniversityFollow
Jeannette D. Hoit, University of Arizona
Elizabeth Pullen, University of ArizonaFollow
Joshua O. Benditt, University of Washington Medical Center
Carolyn Baylor, University of Washington
Kathryn Yorkston, University of WashingtonFollow

Published In

American Journal of Speech-Language Pathology

Document Type

Citation

Publication Date

7-2019

Abstract

Purpose

The aim of this study was to describe experiences of speaking with 2 forms of noninvasive positive pressure ventilation (NPPV)—mouthpiece NPPV (M-NPPV) and nasal bilevel positive airway pressure (BPAP)—in people with neuromuscular disorders who depend on NPPV for survival.

Method

Twelve participants (ages 22−68 years; 10 men, 2 women) with neuromuscular disorders (9 Duchenne muscular dystrophy, 1 Becker muscular dystrophy, 1 postpolio syndrome, and 1 spinal cord injury) took part in semistructured interviews about their speech. All subjects used M-NPPV during the day, and all but 1 used BPAP at night for their ventilation needs. Interviews were audio-recorded, transcribed, and verified. A qualitative descriptive phenomenological approach was used to code and develop themes.

Results

Three major themes emerged from the interview data: (a) M-NPPV aids speaking (by increasing loudness, utterance duration, clarity, and speaking endurance), (b) M-NPPV interferes with the flow of speaking (due to the need to pause to take a breath, problems with mouthpiece placement, and difficulty in using speech recognition software), and (c) nasal BPAP interferes with speaking (by causing abnormal nasal resonance, muffled speech, mask discomfort, and difficulty in coordinating speaking with ventilator-delivered inspirations).

Conclusion

These qualitative data from chronic NPPV users suggest that both M-NPPV and nasal BPAP may interfere with speaking but that speech is usually better and speaking is usually easier with M-NPPV. These findings can be explained primarily by the nature of the 2 ventilator delivery systems and their interfaces.

Description

Copyright © 2020 American Speech-Language-Hearing Association

Locate the Document

http://doi.org/10.1044/2019_AJSLP-MSC18-18-0101

DOI

10.1044/2019_AJSLP-MSC18-18-0101

Persistent Identifier

https://archives.pdx.edu/ds/psu/33029

Citation Details

Britton, D., Hoit, J. D., Pullen, E., Benditt, J. O., Baylor, C. R., & Yorkston, K. M. (2019). Experiences of Speaking With Noninvasive Positive Pressure Ventilation: A Qualitative Investigation. American journal of speech-language pathology, 28(2S), 784-792.