Deshui Li1, Ghizlane Aarab2,3, Frank Lobbezoo2, Patrick Arcache3, Gilles J Lavigne3, Nelly Huynh3. 1. Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. d.li@acta.nl. 2. Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. 3. Faculté de Médicine Dentaire, Université de Montréal, Montreal, Canada.
Abstract
PURPOSE: To determine the effects of a mandibular advancement appliance (MAA) on sequences of jaw-closing muscle activity (JCMA) and apneic or hypopneic event (AHE) in individuals with obstructive sleep apnea (OSA). METHODS: Individuals with OSA were included in a secondary analysis of a randomized controlled crossover trial, in which two ambulatory polysomnographic recordings were performed: one with MAA in situ and the other without MAA. A time span of 16 s between JCMA and AHE was applied to classify JCMAs into four sequences: (1) JCMA occurs before AHE (B-type); (2) both events occur simultaneously (S-type); (3) JCMA occurs after AHE (A-type); and (4) JCMA is time-unrelated to AHE (U-type). The effects of MAA on the distribution of these sequences were analyzed by Wilcoxon signed-rank test. RESULTS: Among 16 individuals (10 men, mean age 51.3 ± 8.5 years) baseline apnea-hypopnea index and JCMA index were 23.8 ± 16.0 events/h and 10.8 ± 10.3 events/h, respectively. In both conditions, i.e., without and with MAA, most JCMAs were U-type (48% and 65%, respectively), followed by A-type (41% and 22%), B-type (25% and 21%), and S-type (2% and 1%). With MAA in situ, only the A-type JCMA index decreased significantly (P = 0.005), while B-type, S-type, and U-type JCMA indices did not change significantly (all P > 0.05). CONCLUSION: MAA therapy only significantly reduces the jaw-closing muscle activities that occur after apneic or hypopneic events in individuals with OSA. TRIAL REGISTRATION: www. CLINICALTRIALS: gov (NCT02011425); December 13, 2013.
PURPOSE: To determine the effects of a mandibular advancement appliance (MAA) on sequences of jaw-closing muscle activity (JCMA) and apneic or hypopneic event (AHE) in individuals with obstructive sleep apnea (OSA). METHODS: Individuals with OSA were included in a secondary analysis of a randomized controlled crossover trial, in which two ambulatory polysomnographic recordings were performed: one with MAA in situ and the other without MAA. A time span of 16 s between JCMA and AHE was applied to classify JCMAs into four sequences: (1) JCMA occurs before AHE (B-type); (2) both events occur simultaneously (S-type); (3) JCMA occurs after AHE (A-type); and (4) JCMA is time-unrelated to AHE (U-type). The effects of MAA on the distribution of these sequences were analyzed by Wilcoxon signed-rank test. RESULTS: Among 16 individuals (10 men, mean age 51.3 ± 8.5 years) baseline apnea-hypopnea index and JCMA index were 23.8 ± 16.0 events/h and 10.8 ± 10.3 events/h, respectively. In both conditions, i.e., without and with MAA, most JCMAs were U-type (48% and 65%, respectively), followed by A-type (41% and 22%), B-type (25% and 21%), and S-type (2% and 1%). With MAA in situ, only the A-type JCMA index decreased significantly (P = 0.005), while B-type, S-type, and U-type JCMA indices did not change significantly (all P > 0.05). CONCLUSION: MAA therapy only significantly reduces the jaw-closing muscle activities that occur after apneic or hypopneic events in individuals with OSA. TRIAL REGISTRATION: www. CLINICALTRIALS: gov (NCT02011425); December 13, 2013.
Authors: Chamara V Senaratna; Jennifer L Perret; Caroline J Lodge; Adrian J Lowe; Brittany E Campbell; Melanie C Matheson; Garun S Hamilton; Shyamali C Dharmage Journal: Sleep Med Rev Date: 2016-07-18 Impact factor: 11.609