Experiences of speaking with noninvasive positive pressure ventilation: A qualitative investigation

Deanna Britton, Jeannette D. Hoit, Elizabeth Pullen, Joshua O. Benditt, Carolyn R. Baylor, Kathryn M. Yorkstonc

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)784-792
Number of pages9
JournalAmerican journal of speech-language pathology
Volume28
Issue number2 Special Issue
DOIs
StatePublished - Jul 2019

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Developmental and Educational Psychology
  • Linguistics and Language
  • Speech and Hearing

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