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Mandibular Movement Analysis to Assess Efficacy of Oral Appliance Therapy in OSA
Journal article   Open access   Peer reviewed

Mandibular Movement Analysis to Assess Efficacy of Oral Appliance Therapy in OSA

Jean-Benoit Martinot, Nam N. Le-Dong, Etienne Crespeigne, Philip E. Silkoff, Valérie Cuthbert, Stéphane Denison, Jean-Christian Borel and Jean-Louis Pépin
Chest, v 154(6), pp 1340-1347
Dec 2018
PMID: 30413243
url
https://doi.org/10.1016/j.chest.2018.08.1027View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Restricted

Abstract

mandibular advancement device mandibular movements oral appliance OSA
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). 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. 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. 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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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Critical Care Medicine
Respiratory System
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