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Martinot J, Hostaux L, Malhotra A, Hwang D, Pépin J. Air leak phenotyping by mandibular jaw movement analysis in CPAP therapy: Key insights for practitioners. Respirol Case Rep 2024; 12:e70030. [PMID: 39319331 PMCID: PMC11421881 DOI: 10.1002/rcr2.70030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 09/12/2024] [Indexed: 09/26/2024] Open
Abstract
Monitoring unintentional air leaks in continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) is essential for therapy success. While leaks are often attributed to improperly sealed masks, mouth openings may also cause them, requiring interventions. Recent studies demonstrated distinctive mandibular jaw movement (MJM) signal patterns during sleep related to respiratory events and sleep stages. Analysing MJM during CPAP treatment reveals air leak peaks coinciding with maximal MJM amplitude during obstructive events, and air leak decreases corresponding to arousals. Examining leaks with MJM offers valuable insights into their origins and might open new avenues for CPAP management.
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Affiliation(s)
- Jean‐Benoit Martinot
- Sleep LaboratoryCHU Université catholique de Louvain (UCL) Namur Site Sainte‐ElisabethNamurBelgium
- Institute of Experimental and Clinical ResearchUCL Bruxelles WoluweBrusselsBelgium
| | - Lorent Hostaux
- Unité de recherche cliniqueCHU Université catholique de Louvain (UCL) Namur Site GodinneYvoirBelgium
| | - Atul Malhotra
- Division of Pulmonary, Critical Care, and Sleep MedicineUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Dennis Hwang
- Kaiser Permanente San Bernardino County Sleep CenterKaiser Permanente Southern CaliforniaFontanaCaliforniaUSA
| | - Jean‐Louis Pépin
- University Grenoble AlpesHP2 LaboratoryGrenobleFrance
- EFCR LaboratoryGrenoble Alpes University HospitalGrenobleFrance
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Alsaif SS, Douglas W, Steier J, Morrell MJ, Polkey MI, Kelly JL. Mandibular movement monitor provides faster, yet accurate diagnosis for obstructive sleep apnoea: A randomised controlled study. Clin Med (Lond) 2024; 24:100231. [PMID: 39047815 PMCID: PMC11345283 DOI: 10.1016/j.clinme.2024.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Many patients with obstructive sleep apnoea (OSA) remain undiagnosed and thus untreated, and in part this relates to delay in diagnosis. Novel diagnostic strategies may improve access to diagnosis. In a multicentre, randomised study, we evaluated time to treatment decision in patients referred for suspected OSA, comparing a mandibular movement (MM) monitor to respiratory polygraphy, the most commonly used OSA detection method in the UK. Adults with high pre-test probability OSA were recruited from both northern Scotland and London. 40 participants (70 % male, mean±SD age 46.8 ± 12.9 years, BMI 36.9 ± 7.5 kg/m2, ESS 14.9 ± 4.1) wore a MM monitor and respiratory polygraphy simultaneously overnight and were randomised (1:1) to receive their treatment decision based on results from either device. Compared to respiratory polygraphy, MM monitor reduced time to treatment decision by 6 days (median(IQR): 13.5 (7.0-21.5) vs. 19.5 (13.7-35.5) days, P = 0.017) and saved an estimated 29 min of staff time per patient.
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Affiliation(s)
- Sulaiman S Alsaif
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Wendy Douglas
- Sleep and Ventilation Services, Raigmore Hospital, NHS Highland, Inverness, United Kingdom
| | - Joerg Steier
- Lane Fox Respiratory Unit/Sleep Disorders Centre, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom; Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Mary J Morrell
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Michael I Polkey
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Sleep and Ventilation Services, Raigmore Hospital, NHS Highland, Inverness, United Kingdom
| | - Julia L Kelly
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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Kelly JL, Ben Messaoud R, Joyeux-Faure M, Terrail R, Tamisier R, Martinot JB, Le-Dong NN, Morrell MJ, Pépin JL. Diagnosis of Sleep Apnoea Using a Mandibular Monitor and Machine Learning Analysis: One-Night Agreement Compared to in-Home Polysomnography. Front Neurosci 2022; 16:726880. [PMID: 35368281 PMCID: PMC8965001 DOI: 10.3389/fnins.2022.726880] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe capacity to diagnose obstructive sleep apnoea (OSA) must be expanded to meet an estimated disease burden of nearly one billion people worldwide. Validated alternatives to the gold standard polysomnography (PSG) will improve access to testing and treatment. This study aimed to evaluate the diagnosis of OSA, using measurements of mandibular movement (MM) combined with automated machine learning analysis, compared to in-home PSG.Methods40 suspected OSA patients underwent single overnight in-home sleep testing with PSG (Nox A1, ResMed, Australia) and simultaneous MM monitoring (Sunrise, Sunrise SA, Belgium). PSG recordings were manually analysed by two expert sleep centres (Grenoble and London); MM analysis was automated. The Obstructive Respiratory Disturbance Index calculated from the MM monitoring (MM-ORDI) was compared to the PSG (PSG-ORDI) using intraclass correlation coefficient and Bland-Altman analysis. Receiver operating characteristic curves (ROC) were constructed to optimise the diagnostic performance of the MM monitor at different PSG-ORDI thresholds (5, 15, and 30 events/hour).Results31 patients were included in the analysis (58% men; mean (SD) age: 48 (15) years; BMI: 30.4 (7.6) kg/m2). Good agreement was observed between MM-ORDI and PSG-ORDI (median bias 0.00; 95% CI −23.25 to + 9.73 events/hour). However, for 15 patients with no or mild OSA, MM monitoring overestimated disease severity (PSG-ORDI < 5: MM-ORDI mean overestimation + 5.58 (95% CI + 2.03 to + 7.46) events/hour; PSG-ORDI > 5–15: MM-ORDI overestimation + 3.70 (95% CI −0.53 to + 18.32) events/hour). In 16 patients with moderate-severe OSA (n = 9 with PSG-ORDI 15–30 events/h and n = 7 with a PSG-ORD > 30 events/h), there was an underestimation (PSG-ORDI > 15: MM-ORDI underestimation −8.70 (95% CI −28.46 to + 4.01) events/hour). ROC optimal cut-off values for PSG-ORDI thresholds of 5, 15, 30 events/hour were: 9.53, 12.65 and 24.81 events/hour, respectively. These cut-off values yielded a sensitivity of 88, 100 and 79%, and a specificity of 100, 75, 96%. The positive predictive values were: 100, 80, 95% and the negative predictive values 89, 100, 82%, respectively.ConclusionThe diagnosis of OSA, using MM with machine learning analysis, is comparable to manually scored in-home PSG. Therefore, this novel monitor could be a convenient diagnostic tool that can easily be used in the patients’ own home.Clinical Trial Registrationhttps://clinicaltrials.gov, identifier NCT04262557
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Affiliation(s)
- Julia L. Kelly
- National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, United Kingdom
| | - Raoua Ben Messaoud
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
| | - Marie Joyeux-Faure
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Thorax and Vessels division, Grenoble Alpes University Hospital, Grenoble, France
| | - Robin Terrail
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Thorax and Vessels division, Grenoble Alpes University Hospital, Grenoble, France
| | - Renaud Tamisier
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Thorax and Vessels division, Grenoble Alpes University Hospital, Grenoble, France
| | - Jean-Benoît Martinot
- Sleep Laboratory, CHU Université catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, Belgium
- Institute of Experimental and Clinical Research, UCL Bruxelles Woluwe, Brussels, Belgium
| | | | - Mary J. Morrell
- National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, United Kingdom
| | - Jean-Louis Pépin
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Thorax and Vessels division, Grenoble Alpes University Hospital, Grenoble, France
- *Correspondence: Jean-Louis Pépin,
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Kjar MR, Brink-Kjar A, Hanif U, Mignot E, Jennum P, Sorensen HBD. Polysomnographic Plethysmography Excursions are Reduced in Obese Elderly Men. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:2396-2399. [PMID: 34891764 DOI: 10.1109/embc46164.2021.9630145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sleep apnea is a widespread disorder and is defined by the complete or partial cessation of breathing. Obstructive sleep apnea (OSA) is caused by an obstruction in the upper airway while central sleep apnea (CSA) is characterized by a diminished or absent respiratory effort. It is crucial to differentiate between these respiratory subtypes as they require radically different treatments. Currently, diagnostic polysomnography (PSG) is used to determine respiratory thoracic and abdominal movement patterns using plethysmography belt signals, to distinguish between OSA and CSA. There is significant manual technician interrater variability between these classifications, especially in the evaluation of CSA. We hypothesize that an increased body mass index (BMI) will cause decreased belt signal excursions that increase false scorings of CSA. The hypothesis was investigated by calculating the envelope as a continuous signal of belt signals in 2833 subjects from the MrOS Sleep Study and extracting a mean value of each of the envelopes for each subject. Using linear regression, we found that an increased BMI was associated with lower excursions during REM sleep (-0.013 [mV] thoracic and -0.018 [mV] abdominal, per BMI) and non-REM (-0.014 [mV] thoracic and -0.012 [mV] abdominal, per BMI). We conclude that increased BMI leads to lower excursions in the belt signals during event-free sleep, and that OSA and CSA events are harder to distinguish in subjects with high BMI. This has a major implication for the correct identification of CSA/OSA and its treatment.
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Sanz PM, Reyes MG, Torras AB, Castillo JAC, Vich MOL. Craniofacial morphology/phenotypes influence on mandibular range of movement in the design of a mandibular advancement device. BMC Oral Health 2021; 21:19. [PMID: 33413283 PMCID: PMC7791719 DOI: 10.1186/s12903-020-01369-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 12/16/2020] [Indexed: 12/02/2022] Open
Abstract
Background The mandibular opening path movements have different directions according to the craniofacial morphology of the patient but always downward and backward, therefore increasing the collapse of the upper airway. The aim of this work is to determine if there is a relationship between the craniofacial morphology and the mandibular movement to help understand the impact on the mandibular position. Methods 52 students with full permanent dentition aged 19 to 23 years (mean 21.3 SD 1.7; 29 females and 23 males), participated in the study. Each subject had a lateral cephalometric radiograph taken. The opening angle was determined for two levels of vertical openings at 5 and 10 mm. Results The opening angle showed a greater variability between subjects ranging from 63.15 to 77.08 for 5 mm angle and from for 61.65 to 75.72 for the 10 mm angle. Differences of facial phenotypes was evident when comparing the individual dissoccluding angle of the low angle horizontal pattern and high angle vertical pattern. Conclusions The opening angle is related to craniofacial morphology with higher vertical anterior and shorter anteroposterior faces having a more horizontal path of mandibular movement than shorter vertical anterior and longer anteroposterior subjects who have a more vertical path.
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Affiliation(s)
- P Mayoral Sanz
- Master Program Dental Sleep Medicine, Catholic University of Murcia UCAM, Conde de Peñalver 61, 28006, Madrid, Spain
| | - M Garcia Reyes
- Faculty of Engineering, University of Malaga, Flauta Mágica 22, 29006, Málaga, Spain
| | - A Bataller Torras
- Faculty of Engineering, University of Malaga, Flauta Mágica 22, 29006, Málaga, Spain
| | - J A Cabrera Castillo
- Faculty of Engineering, University of Malaga, Flauta Mágica 22, 29006, Málaga, Spain
| | - M O Lagravère Vich
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta ECHA, 5-524, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada.
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García M, Cabrera JA, Bataller A, Vila J, Mayoral P. Mandibular movement analisys by means of a kinematic model applied to the design of oral appliances for the treatment of obstructive sleep apnea. Sleep Med 2020; 73:29-37. [PMID: 32769030 DOI: 10.1016/j.sleep.2020.04.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/16/2020] [Accepted: 04/19/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mandibular advancement devices (MADs) are one of the treatment options used for the obstructive sleep apnea syndrome (OSAS). At present, MADs are designed with standard titration systems, without considering each patient's anatomical characteristics of the temporomandibular joint and mandible shape. The main objective of this study is to evaluate if a variability in mandibular morphology will influence the displacement of the jaw with a MAD. Such knowledge will be of help to find optimal mandibular positions with MAD even when opening the mouth. METHODS By using a mandibular movement model, the movement patterns of different points on the chin have been analyzed. The influence of different skeletal mandibular shapes on these movements have also been studied. The results show differences in the movement patterns of the lower front teeth depending on its distance to the center of the condyle, with a more horizontal direction in those in which there is a greater distance. RESULTS Variations in mandibular morphology imply differences in movement patterns of the analyzed points of the mandible. Consequently, MADs should be designed according to each patient's anatomy to avoid mandibular retrusion in those areas that may narrow the upper airways. CONCLUSIONS This study may help to understand why not all patients move their lower jaws forwards equally with the same degree of mandibular protrusion measured in relation to the teeth. These results might also partially explain why airway obstruction is more severe in certain untreated sleep apnea subjects than in others when opening their mouth during sleep.
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Affiliation(s)
- Marcos García
- Department of Mechanical Engineering, University of Málaga, Spain
| | - Juan A Cabrera
- Department of Mechanical Engineering, University of Málaga, Spain.
| | - Alex Bataller
- Department of Mechanical Engineering, University of Málaga, Spain
| | - Javier Vila
- Otorhinolaryngology, Hospital Vall d Hebron, Barcelona, Spain
| | - Pedro Mayoral
- Master Program of Dental Sleep Medicine, Catholic University of Murcia, Spain
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Synchronized mandibular movement and capnography: a novel approach to obstructive airway detection during procedural sedation-a post hoc analysis of a prospective study. J Clin Monit Comput 2019; 33:1065-1070. [PMID: 30610518 DOI: 10.1007/s10877-018-00250-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 12/31/2018] [Indexed: 01/29/2023]
Abstract
Perioperative complications related to obstructive sleep apnea still occur despite the use of partial pressure end-tidal CO2[Formula: see text] and pulse oximetry. Airway obstruction can complicate propofol sedation and a novel monitor combining mandibular movement analysis with capnography may facilitate its detection. Patients scheduled for sleep endoscopy were recruited and monitored with standard monitoring, [Formula: see text] and Jaw Activity (JAWAC) mandibular movement sensors. A post hoc analysis investigated airway obstruction prediction using a Respiratory Effort Sequential Detection Algorithm (RESDA) based on [Formula: see text] and mandibular movement signals. 21 patients were recruited and 54 episodes of airway obstruction occurred. RESDA detected obstructive apnea [mean ± SD (median)] 29 ± 29 (21) s, p < 0.0001, before [Formula: see text] alone. This prolonged the time between obstructive apnea detection and decrease to 90% oxygen saturation 64 ± 38 (54) versus 38 ± 20 (35) s, p < 0.0001. It predicted airway obstruction with a sensitivity and specificity of 81% and 93%, respectively. The RESDA algorithm, which is based on the combination of capnography with mandibular movement assessment of respiratory effort, can more rapidly alarm anesthetists of airway obstruction during propofol sedation than [Formula: see text] alone. However, [Formula: see text] pulse oximetry, and clinical monitoring are still required.Trial Registry numbers: ClinicalTrial.gov (NCT02909309) https://clinicaltrials.gov/ct2/show/NCT02909309 .
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Martinot JB, Le-Dong NN, Crespeigne E, Silkoff PE, Cuthbert V, Denison S, Borel JC, Pépin JL. Mandibular Movement Analysis to Assess Efficacy of Oral Appliance Therapy in OSA. Chest 2018; 154:1340-1347. [DOI: 10.1016/j.chest.2018.08.1027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/11/2018] [Accepted: 08/01/2018] [Indexed: 11/29/2022] Open
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Piper AJ, Wort SJ, Renzoni EA, Kouranos V. Year in review 2017: Interstitial lung disease, pulmonary vascular disease and sleep. Respirology 2018; 23:421-433. [PMID: 29471594 DOI: 10.1111/resp.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 02/01/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Amanda J Piper
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Stephen J Wort
- Pulmonary Hypertension Department, Royal Brompton Hospital, Imperial College, London, UK
| | - Elisabetta A Renzoni
- Interstitial Lung Disease Unit, Royal Brompton Hospital, Imperial College, London, UK
| | - Vasileios Kouranos
- Interstitial Lung Disease Unit, Royal Brompton Hospital, Imperial College, London, UK
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Martinot JB, Borel JC, Le-Dong NN, Guénard HJP, Cuthbert V, Silkoff PE, Gozal D, Pepin JL. Monitoring mandibular movements to detect Cheyne-Stokes Breathing. Respir Res 2017; 18:66. [PMID: 28427400 PMCID: PMC5399309 DOI: 10.1186/s12931-017-0551-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 04/12/2017] [Indexed: 12/01/2022] Open
Abstract
Background The patterns of mandibular movements (MM) during sleep can be used to identify increased respiratory effort periodic large-amplitude MM (LPM), and cortical arousals associated with “sharp” large-amplitude MM (SPM). We hypothesized that Cheyne Stokes breathing (CSB) may be identified by periodic abnormal MM patterns. The present study aims to evaluate prospectively the concordance between CSB detected by periodic MM and polysomnography (PSG) as gold-standard. The present study aims to evaluate prospectively the concordance between CSB detected by periodic MM and polysomnography (PSG) as gold-standard. Methods In 573 consecutive patients attending an in-laboratory PSG for suspected sleep disordered breathing (SDB), MM signals were acquired using magnetometry and scored manually while blinded from the PSG signal. Data analysis aimed to verify the concordance between the CSB identified by PSG and the presence of LPM or SPM. The data were randomly divided into training and validation sets (985 5-min segments/set) and concordance was evaluated using 2 classification models. Results In PSG, 22 patients (mean age ± SD: 65.9 ± 15.0 with a sex ratio M/F of 17/5) had CSB (mean central apnea hourly indice ± SD: 17.5 ± 6.2) from a total of 573 patients with suspected SDB. When tested on independent subset, the classification of CSB based on LPM and SPM is highly accurate (Balanced-accuracy = 0.922, sensitivity = 0.922, specificity = 0.921 and error-rate = 0.078). Logistic models based odds-ratios for CSB in presence of SPM or LPM were 172.43 (95% CI: 88.23–365.04; p < 0.001) and 186.79 (95% CI: 100.48–379.93; p < 0.001), respectively. Conclusion CSB in patients with sleep disordered breathing could be accurately identified by a simple magnetometer device recording mandibular movements.
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Affiliation(s)
- Jean-Benoît Martinot
- Centre du Sommeil et de la Vigilance, CHU UCL Namur Site Ste Elisabeth, 15, Place Louise Godin, 5000, Namur, Belgium.
| | - Jean-Christian Borel
- AGIR à dom. Association, 38240, Meylan, France.,University Grenoble Alpes, HP2 INSERM U1042, 38000, Grenoble, France
| | | | | | - Valerie Cuthbert
- Centre du Sommeil et de la Vigilance, CHU UCL Namur Site Ste Elisabeth, 15, Place Louise Godin, 5000, Namur, Belgium
| | | | | | - Jean-Louis Pepin
- University Grenoble Alpes, HP2 INSERM U1042, 38000, Grenoble, France.,CHU de Grenoble, Laboratoire EFCR, Pôle THORAX et VAISSEAUX, Grenoble, France
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Gray EL, Barnes DJ. Beyond the thermistor: Novel technology for the ambulatory diagnosis of obstructive sleep apnoea. Respirology 2017; 22:418-419. [DOI: 10.1111/resp.13004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 01/19/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Emma L. Gray
- Department of Respiratory and Sleep Medicine; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - David J. Barnes
- Department of Respiratory and Sleep Medicine; Royal Prince Alfred Hospital; Sydney New South Wales Australia
- Department of Medicine; University of Sydney; Sydney New South Wales Australia
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Chakar B, Senny F, Poirrier AL, Cambron L, Fanielle J, Poirrier R. Validation of midsagittal jaw movements to measure sleep in healthy adults by comparison with actigraphy and polysomnography. ACTA ACUST UNITED AC 2017; 10:122-127. [PMID: 29410741 PMCID: PMC5699855 DOI: 10.5935/1984-0063.20170021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE In a device based on midsagittal jaw movements analysis, we assessed a
sleep-wake automatic detector as an objective method to measure sleep in
healthy adults by comparison with wrist actigraphy against polysomnography
(PSG). METHODS Simultaneous and synchronized in-lab PSG, wrist actigraphy and jaw movements
were carried out in 38 healthy participants. Epoch by epoch analysis was
realized to assess the ability to sleep-wake distinction. Sleep parameters
as measured by the three devices were compared. This included three
regularly reported parameters: total sleep time, sleep onset latency, and
wake after sleep onset. Also, two supplementary parameters, wake during
sleep period and latency time, were added to measure quiet wakefulness
state. RESULTS The jaw movements showed sensitivity level equal to actigraphy 96% and
higher specificity level (64% and 48% respectively). The level of agreement
between the two devices was high (87%). The analysis of their disagreement
by discrepant resolution analysis used PSG as resolver revealed that jaw
movements was right (58.9%) more often than actigraphy (41%). In sleep
parameters comparison, the coefficient correlation of jaw movements was
higher than actigraphy in all parameters. Moreover, its ability to distinct
sleep-wake state allowed for a more effective estimation of the parameters
that measured the quiet wakefulness state. CONCLUSIONS Midsagittal jaw movements analysis is a reliable method to measure sleep. In
healthy adults, this device proved to be superior to actigraphy in terms of
estimation of all sleep parameters and distinction of sleep-wake status.
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Affiliation(s)
- Bassam Chakar
- University Hospital of Liege, Sleep Center - Department of Neurology - Liège - Liège - Belgium
| | - Frédéric Senny
- High School HELMo-Gramme, Electronic and Informatic Unit - Liège - Liège - Belgium
| | - Anne-Lise Poirrier
- University Hospital of Liege, Rhinology and Facial Plastic Surgery - Liège - Liège - Belgium
| | - Laurent Cambron
- University Hospital of Liege, Sleep Center - Department of Neurology - Liège - Liège - Belgium
| | - Julien Fanielle
- University Hospital of Liege, Sleep Center - Department of Neurology - Liège - Liège - Belgium
| | - Robert Poirrier
- University Hospital of Liege, Sleep Center - Department of Neurology - Liège - Liège - Belgium
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Martinot JB, Borel JC, Cuthbert V, Guénard HJP, Denison S, Silkoff PE, Gozal D, Pepin JL. Mandibular position and movements: Suitability for diagnosis of sleep apnoea. Respirology 2016; 22:567-574. [DOI: 10.1111/resp.12929] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/16/2016] [Accepted: 08/16/2016] [Indexed: 11/29/2022]
Affiliation(s)
| | - Jean-Christian Borel
- ‘AGIR à dom’ Association, La Tronche; Grenoble France
- University Grenoble Alpes; Grenoble France
| | | | | | | | - Philip E. Silkoff
- Department of Physiology; Temple University; Philadelphia Pennsylvania USA
| | - David Gozal
- Department of Medicine; University of Chicago; Chicago Illinois USA
| | - Jean-Louis Pepin
- University Grenoble Alpes; Grenoble France
- Sleep and Exercise Laboratory; Thorax and Vessels Division, Grenoble Alpes University Hospital; Grenoble France
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Vandenbussche NL, Overeem S, van Dijk JP, Simons PJ, Pevernagie DA. Assessment of respiratory effort during sleep: Esophageal pressure versus noninvasive monitoring techniques. Sleep Med Rev 2015; 24:28-36. [DOI: 10.1016/j.smrv.2014.12.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 12/18/2014] [Accepted: 12/19/2014] [Indexed: 10/24/2022]
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