Tracking jaw movements is a useful tool for measuring the efficacy of oral appliances, according to a new study in the journal CHEST®
While continuous positive airway pressure (CPAP) continues to be the gold standard for treatment of sleep apnea, the cumbersome machines are often not well tolerated by patients.
Because of this, less obtrusive oral appliances that thrust the jaw forward during sleep are becoming more popular. Mandibular protrusion enlarges the pharynx and stabilizes the upper airway. A new study in CHEST® demonstrates that mandibular movements (MM) monitoring can be used to assess the efficacy of these oral appliances.
MM during sleep are accurate reporters for increased respiratory effort and micro arousals found in people with sleep apnea. In this sleep study, 56 patients with obstructive sleep apnea (OSA) were fitted with a custom mandibular advancement splint (OAT) and had their midsagittal mandibular movement tracked.
Patients were evaluated at the end of the titration procedure. During the titration procedure different degrees of advancement are trialed up and down to find the single best amount to control apnea events for that patient.
"The novelty of the study related to tracking sleep MM in order to assess oral appliance therapy effectiveness," explained lead investigator Jean-Benoit Martinot, MD, Sleep Laboratory, CHU UCL Namur Site Sainte-Elisabeth, Namur, Belgium. "Our study suggested for the first time that MM monitoring represents a powerful tool for assessing the efficacy of OAT treatment."
Investigators found that by the end of titration, all indications of OSA decreased compared with baseline. Overall, patients showed a reduction of vertical respiratory MM and sleep respiratory effort, as well as a dramatic decrease in obstructive hypopnea. Scores from the apnea-hypopnea index and oxygen desaturation index also dropped.
"Using MM measurements in the oral appliance titration procedure has the potential to optimize the benefit/risk ratio of oral appliances," said Dr. Martinot. "There is a high interindividual variability in response to the oral appliances, and it is difficult to predict the range of responses without proper measurement."
Researchers also found that MM monitoring helped to reveal the presence of central apneas. They found in a subgroup of subjects a decrease in respiratory effort, but no improvement or an increase in sharp and sudden MM of high amplitude, which indicates persistent sleep fragmentation. This is highly suggestive of emergent central apneas and may shed light on a possible predictor for poor response to OAT.
With new technology on the horizon, MM monitoring could potentially represent a cost-effective and easy-to-implement tool for sleep clinics to use when titrating oral appliances.
"MM monitoring during sleep is practical and informative for measuring indices of residual respiratory events when OSA is treated by oral appliances," concluded Dr. Martinot. "Given the growing use of this treatment as the primary alternative to CPAP, these data are relevant for sleep clinicians.
Andrea Camino | EurekAlert!
Risk of infection with COVID-19 from singing: First results of aerosol study with the Bavarian Radio Chorus
03.07.2020 | Klinikum der Universität München
Age research: A low level of the stress hormone cortisol contributes to the ageing process
01.07.2020 | Universität des Saarlandes
Solar cells based on perovskite compounds could soon make electricity generation from sunlight even more efficient and cheaper. The laboratory efficiency of these perovskite solar cells already exceeds that of the well-known silicon solar cells. An international team led by Stefan Weber from the Max Planck Institute for Polymer Research (MPI-P) in Mainz has found microscopic structures in perovskite crystals that can guide the charge transport in the solar cell. Clever alignment of these "electron highways" could make perovskite solar cells even more powerful.
Solar cells convert sunlight into electricity. During this process, the electrons of the material inside the cell absorb the energy of the light....
Empa researchers have succeeded in applying aerogels to microelectronics: Aerogels based on cellulose nanofibers can effectively shield electromagnetic radiation over a wide frequency range – and they are unrivalled in terms of weight.
Electric motors and electronic devices generate electromagnetic fields that sometimes have to be shielded in order not to affect neighboring electronic...
A promising operating mode for the plasma of a future power plant has been developed at the ASDEX Upgrade fusion device at Max Planck Institute for Plasma...
Live event – July 1, 2020 - 11:00 to 11:45 (CET)
"Automation in Aerospace Industry @ Fraunhofer IFAM"
The Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM l Stade is presenting its forward-looking R&D portfolio for the first time at...
With an X-ray experiment at the European Synchrotron ESRF in Grenoble (France), Empa researchers were able to demonstrate how well their real-time acoustic monitoring of laser weld seams works. With almost 90 percent reliability, they detected the formation of unwanted pores that impair the quality of weld seams. Thanks to a special evaluation method based on artificial intelligence (AI), the detection process is completed in just 70 milliseconds.
Laser welding is a process suitable for joining metals and thermoplastics. It has become particularly well established in highly automated production, for...
02.07.2020 | Event News
19.05.2020 | Event News
07.04.2020 | Event News
06.07.2020 | Health and Medicine
06.07.2020 | Social Sciences
06.07.2020 | Materials Sciences