Jean-Benoit Martinot1, Jean-Christian Borel2,3, Valérie Cuthbert1, Hervé Jean-Pierre Guénard4, Stéphane Denison1, Philip E Silkoff5, David Gozal6, Jean-Louis Pepin3,7. 1. Laboratory of Sleep Medicine, CHU UCL Namur, Namur, Belgium. 2. 'AGIR à dom' Association, La Tronche, Grenoble, France. 3. University Grenoble Alpes, Grenoble, France. 4. Laboratory of Physiology, Bordeaux University, Bordeaux, France. 5. Department of Physiology, Temple University, Philadelphia, Pennsylvania, USA. 6. Department of Medicine, University of Chicago, Chicago, Illinois, USA. 7. Sleep and Exercise Laboratory, Thorax and Vessels Division, Grenoble Alpes University Hospital, Grenoble, France.
Abstract
BACKGROUND AND OBJECTIVE: Mandibular movements (MMs) and position during sleep reflect respiratory efforts related to increases in upper airway resistance and micro-arousals. The study objective was to assess whether MM identifies sleep-disordered breathing (SDB) in patients with moderate to high pre-test probability. METHODS: This was a prospective study of 87 consecutive patients referred for an in-laboratory sleep test. Magnetometer-derived MM signals were incorporated into standard polysomnography (PSG). Respiratory events detected with MM analysis were compared with PSG for respiratory disturbance index (RDI) with a blinded scoring. All records were scored manually according to American Academy of Sleep Medicine rules. Primary outcome was to rule-in obstructive sleep apnoea syndrome (OSAS) defined as RDI cut-off value ≥5 or 15/h total sleep time (TST). RESULTS: High concordance emerged between MM and PSG-derived RDI with high temporal coincidence between events (R2 = 0.906; P < 0.001). The mean diagnostic accuracy of MM for OSAS using RDI MM cut-off values of 5.9 and 13.5 was 0.935 (0.86-0.97) and 0.913 (0.84-0.95), with a mean positive likelihood ratio (LLR+) of 3.73 (2.7-20.4) and 8.46 (2.3-31.5), respectively. Receiver operating characteristic (ROC) curves at PSG cut-off values of 5 and 15/h TST had areas under the curve (AUC) of 0.96 (95% CI: 0.89-0.99) and 0.97 (95% CI: 0.91-0.99) (P < 0.001), respectively. MM analysis accurately identified SDB at different levels of severity. CONCLUSION: RDI assessed by MM is highly concordant with PSG, suggesting a role of ambulatory MM recordings to screen for SDB in patients with moderate to high pre-test probability.
BACKGROUND AND OBJECTIVE: Mandibular movements (MMs) and position during sleep reflect respiratory efforts related to increases in upper airway resistance and micro-arousals. The study objective was to assess whether MM identifies sleep-disordered breathing (SDB) in patients with moderate to high pre-test probability. METHODS: This was a prospective study of 87 consecutive patients referred for an in-laboratory sleep test. Magnetometer-derived MM signals were incorporated into standard polysomnography (PSG). Respiratory events detected with MM analysis were compared with PSG for respiratory disturbance index (RDI) with a blinded scoring. All records were scored manually according to American Academy of Sleep Medicine rules. Primary outcome was to rule-in obstructive sleep apnoea syndrome (OSAS) defined as RDI cut-off value ≥5 or 15/h total sleep time (TST). RESULTS: High concordance emerged between MM and PSG-derived RDI with high temporal coincidence between events (R2 = 0.906; P < 0.001). The mean diagnostic accuracy of MM for OSAS using RDI MM cut-off values of 5.9 and 13.5 was 0.935 (0.86-0.97) and 0.913 (0.84-0.95), with a mean positive likelihood ratio (LLR+) of 3.73 (2.7-20.4) and 8.46 (2.3-31.5), respectively. Receiver operating characteristic (ROC) curves at PSG cut-off values of 5 and 15/h TST had areas under the curve (AUC) of 0.96 (95% CI: 0.89-0.99) and 0.97 (95% CI: 0.91-0.99) (P < 0.001), respectively. MM analysis accurately identified SDB at different levels of severity. CONCLUSION: RDI assessed by MM is highly concordant with PSG, suggesting a role of ambulatory MM recordings to screen for SDB in patients with moderate to high pre-test probability.
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