Jean-Benoît Martinot1, Fréderic Senny2, Stéphane Denison1, Valérie Cuthbert1, Emmanuelle Gueulette1, Hervé Guénard3, Jean-Louis Pépin4. 1. Départements de Pneumologie et de Pédiatrie, Clinique et Maternité St Elisabeth, Namur, Belgium. 2. Electronic unit, HELMo-Gramme, Liège, Belgium. 3. Laboratoire de Physiologie et CHU de Bordeaux, France. 4. Université Grenoble Alpes, HP2; Inserm U1042, Grenoble, France. CHU de Grenoble, Laboratoire EFCR, Secteur Physiologie Sommeil et Exercice, Pole THORAX et VAISSEAUX Grenoble, France.
Abstract
STUDY OBJECTIVES: Obstructive sleep apnea-hypopnea (OAH) diagnosis in children is based on the quantification of flow and respiratory effort (RE). Pulse transit time (PTT) is one validated tool to recognize RE. Pattern analysis of mandibular movements (MM) might be an alternative method to detect RE. We compared several patterns of MM to concomittant changes in PTT during OAH in children with adenotonsillar hypertrophy. PARTICIPANTS: 33 consecutive children with snoring and symptoms/signs of OAH. MEASUREMENTS: MMs were measured during polysomnography with a magnetometer device (Brizzy Nomics, Liege, Belgium) placed on the chin and forehead. Patterns of MM were evaluated representing peak to peak fluctuations > 0.3 mm in mandibular excursion (MML), mandibular opening (MMO), and sharp MM (MMS), which closed the mouth on cortical arousal (CAr). RESULTS: The median (95% CI) hourly rate of at least 1 MM (MML, or MMO, or MMS) was 18.1 (13.2-36.3) and strongly correlated with OAHI (p = 0.003) but not with central apnea-hypopnea index (CAHI; p = 0.292). The durations when the MM amplitude was > 0.4 mm and PTT > 15 ms were strongly correlated (p < 0.001). The mean (SD) of MM peak to peak amplitude was larger during OAH than CAH (0.9 ± 0.7 mm and 0.2 ± 0.3 mm; p < 0.001, respectively). MMS at the termination of OAH had larger amplitude compared to MMS with CAH (1.5 ± 0.9 mm and 0.5 ± 0.7 mm, respectively, p < 0.001). CONCLUSIONS: MM > 0.4 mm occurred frequently during periods of OAH and were frequently terminated by MMS corresponding to mouth closure on CAr. The MM findings strongly correlated with changes in PTT. MM analysis could be a simple and accurate promising tool for RE characterization and optimization of OAH diagnosis in children.
STUDY OBJECTIVES: Obstructive sleep apnea-hypopnea (OAH) diagnosis in children is based on the quantification of flow and respiratory effort (RE). Pulse transit time (PTT) is one validated tool to recognize RE. Pattern analysis of mandibular movements (MM) might be an alternative method to detect RE. We compared several patterns of MM to concomittant changes in PTT during OAH in children with adenotonsillar hypertrophy. PARTICIPANTS: 33 consecutive children with snoring and symptoms/signs of OAH. MEASUREMENTS: MMs were measured during polysomnography with a magnetometer device (Brizzy Nomics, Liege, Belgium) placed on the chin and forehead. Patterns of MM were evaluated representing peak to peak fluctuations > 0.3 mm in mandibular excursion (MML), mandibular opening (MMO), and sharp MM (MMS), which closed the mouth on cortical arousal (CAr). RESULTS: The median (95% CI) hourly rate of at least 1 MM (MML, or MMO, or MMS) was 18.1 (13.2-36.3) and strongly correlated with OAHI (p = 0.003) but not with central apnea-hypopnea index (CAHI; p = 0.292). The durations when the MM amplitude was > 0.4 mm and PTT > 15 ms were strongly correlated (p < 0.001). The mean (SD) of MM peak to peak amplitude was larger during OAH than CAH (0.9 ± 0.7 mm and 0.2 ± 0.3 mm; p < 0.001, respectively). MMS at the termination of OAH had larger amplitude compared to MMS with CAH (1.5 ± 0.9 mm and 0.5 ± 0.7 mm, respectively, p < 0.001). CONCLUSIONS: MM > 0.4 mm occurred frequently during periods of OAH and were frequently terminated by MMS corresponding to mouth closure on CAr. The MM findings strongly correlated with changes in PTT. MM analysis could be a simple and accurate promising tool for RE characterization and optimization of OAH diagnosis in children.
Authors: Jong Yong A Foo; Stephen J Wilson; Andrew P Bradley; Gordon R Williams; Margaret-Anne Harris; David M Cooper Journal: Chest Date: 2005-10 Impact factor: 9.410
Authors: Julia L Kelly; Raoua Ben Messaoud; Marie Joyeux-Faure; Robin Terrail; Renaud Tamisier; Jean-Benoît Martinot; Nhat-Nam Le-Dong; Mary J Morrell; Jean-Louis Pépin Journal: Front Neurosci Date: 2022-03-15 Impact factor: 4.677