Ghizlane Aarab1,2, Patrick Arcache2, Gilles J Lavigne2, Frank Lobbezoo1, Nelly Huynh2. 1. Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. 2. Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada.
Abstract
STUDY OBJECTIVES: The main aim of this study was to investigate the effects of mandibular advancement appliance (MAA) therapy on jaw-closing muscle activity (JCMA) time-related to respiratory arousals, and on JCMA time-related to nonrespiratory arousals in patients with obstructive sleep apnea. METHODS:Eighteen patients with OSA (mean ± standard deviation = 49.4 ± 9.8 years) with a mean ± standard deviation apnea-hypopnea index of 22.0 ± 16.0 events/h of sleep participated in a randomized controlled crossover trial in which two ambulatory polysomnographic recordings, 1 with an MAA in situ and another without the MAA in situ, were performed. JCMA was quantified as the sum of rhythmic masticatory muscle activities and other orofacial activities. RESULTS: Significant reductions in the apnea-hypopnea index (Z = -2.984; P = .003), in the respiratory arousal index (Z = -2.896; P = .004), and in the JCMA time-related to respiratory arousal index (Z = -3.434; P = .001) were found with MAA in situ. On the nonrespiratory arousal index, and on the JCMA time-related to nonrespiratory arousal index, MAA had no significant effect (T = 2.23; P = .82; and Z = -0.66; P = .51, respectively). CONCLUSIONS: This study shows that effective mandibular advancement appliance therapy significantly reduces jaw-closing muscle activities time-related to respiratory arousals in OSA patients. Future studies are needed to confirm these findings in obstructive sleep apnea patients with comorbid sleep bruxism. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: The Effects of Oral Appliance Therapy on Masseter Muscle Activity in Obstructive Sleep Apnea; Identifier: NCT02011425.
RCT Entities:
STUDY OBJECTIVES: The main aim of this study was to investigate the effects of mandibular advancement appliance (MAA) therapy on jaw-closing muscle activity (JCMA) time-related to respiratory arousals, and on JCMA time-related to nonrespiratory arousals in patients with obstructive sleep apnea. METHODS: Eighteen patients with OSA (mean ± standard deviation = 49.4 ± 9.8 years) with a mean ± standard deviation apnea-hypopnea index of 22.0 ± 16.0 events/h of sleep participated in a randomized controlled crossover trial in which two ambulatory polysomnographic recordings, 1 with an MAA in situ and another without the MAA in situ, were performed. JCMA was quantified as the sum of rhythmic masticatory muscle activities and other orofacial activities. RESULTS: Significant reductions in the apnea-hypopnea index (Z = -2.984; P = .003), in the respiratory arousal index (Z = -2.896; P = .004), and in the JCMA time-related to respiratory arousal index (Z = -3.434; P = .001) were found with MAA in situ. On the nonrespiratory arousal index, and on the JCMA time-related to nonrespiratory arousal index, MAA had no significant effect (T = 2.23; P = .82; and Z = -0.66; P = .51, respectively). CONCLUSIONS: This study shows that effective mandibular advancement appliance therapy significantly reduces jaw-closing muscle activities time-related to respiratory arousals in OSA patients. Future studies are needed to confirm these findings in obstructive sleep apneapatients with comorbid sleep bruxism. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: The Effects of Oral Appliance Therapy on Masseter Muscle Activity in Obstructive Sleep Apnea; Identifier: NCT02011425.
Authors: Kannan Ramar; Leslie C Dort; Sheri G Katz; Christopher J Lettieri; Christopher G Harrod; Sherene M Thomas; Ronald D Chervin Journal: J Clin Sleep Med Date: 2015-07-15 Impact factor: 4.062
Authors: Bing Lam; Kim Sam; Wendy Y W Mok; Man Tat Cheung; Daniel Y T Fong; Jamie C M Lam; David C L Lam; Loretta Y C Yam; Mary S M Ip Journal: Thorax Date: 2006-11-22 Impact factor: 9.139