Mandibular Movement Analysis to Assess Efficacy of Oral Appliance Therapy in OSA.
(2018) Chest : the cardiopulmonary and critical care journal — Vol. 154, n° 6, p. 1340-1347 (2018)
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- (en) RATIONALE: The respiratory effort index derived from vertical mandibular movements (MM-REI) is a potential marker of increased respiratory effort during sleep. We evaluated the effectiveness of mandibular advancement splint therapy using MM-REI, in comparison with the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). METHODS: Fifty-six subjects (median age, 47 years) with OSA treated with a custom mandibular advancement splint (Herbst appliance) were evaluated at the end of the titration procedure when snoring was reported absent by the sleep partner. We employed a magnetometer to capture mandibular movements (Brizzy; Nomics). Mandibular advancement splint efficacy was assessed as the percent change from baseline, using Bayesian multilevel models. RESULTS: At the end of titration, all indices of OSA severity decreased compared with baseline: AHI (-48.9% to -71.1%), ODI (-49.5% to -77.2%), with obstructive hypopnea index and MM-REI showing the largest responses (-70.6% to -88.5% and -69.5% to -96.3%, respectively). MM-REI normalization via reductions in both mandibular movement event rate and duration accurately reflected efficacy of the appliance. CONCLUSIONS: The reduction of vertical respiratory mandibular movements estimated by MM-REI and sleep respiratory effort duration accompanied the decrease in obstructive hypopneas, AHI, and ODI when snoring resolved in subjects with OSA treated with an optimally titrated mandibular advancement splint.
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Martinot, J.-B., Le-Dong, N. N., Crespeigne, E., Silkoff, P. E., Cuthbert, V., Denison, S., Borel, J.-C., & Pépin, J.-L. (2018). Mandibular Movement Analysis to Assess Efficacy of Oral Appliance Therapy in OSA. Chest : the cardiopulmonary and critical care journal, 154(6), 1340-1347. https://doi.org/10.1016/j.chest.2018.08.1027 (Original work published 2018)