Mandibular Jaw Movement Automated Analysis for Oral Appliance Monitoring in Obstructive Sleep Apnea: A Prospective Cohort Study.

Autor: Pépin JL; Laboratoire HP2, Institut National de la Santé et de la Recherche Médicale, U1300, Université Grenoble Alpes, Grenoble, France.; Laboratoire Exploration Fonctionnelle Cardio-Respiratoire (EFCR), Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France., Cistulli PA; Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.; Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia., Crespeigne E; Laboratoire du sommeil, Centre Hospitalier Universitaire (CHU) Université catholique de Louvain (UCL), Site Sainte-Elisabeth, Namur, Belgium., Tamisier R; Laboratoire HP2, Institut National de la Santé et de la Recherche Médicale, U1300, Université Grenoble Alpes, Grenoble, France.; Laboratoire Exploration Fonctionnelle Cardio-Respiratoire (EFCR), Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France., Bailly S; Laboratoire HP2, Institut National de la Santé et de la Recherche Médicale, U1300, Université Grenoble Alpes, Grenoble, France.; Laboratoire Exploration Fonctionnelle Cardio-Respiratoire (EFCR), Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France., Bruwier A; Département D'orthodontie et Orthopédie Dentofaciale, Centre Hospitalier Universitaire (CHU) de Liège, Liège, Belgium., Le-Dong NN; Sunrise, Namur, Belgium., Lavigne G; Department of Oral Health, Faculty of Dental Medicine, University of Montréal, Montréal, Québec, Canada.; Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal (CIUSSS NIM) et Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada., Malhotra A; University of California, San Diego, La Jolla, California; and., Martinot JB; Laboratoire du sommeil, Centre Hospitalier Universitaire (CHU) Université catholique de Louvain (UCL), Site Sainte-Elisabeth, Namur, Belgium.; Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain Bruxelles Woluwe, Bruxelles, Belgium.
Jazyk: angličtina
Zdroj: Annals of the American Thoracic Society [Ann Am Thorac Soc] 2024 May; Vol. 21 (5), pp. 814-822.
DOI: 10.1513/AnnalsATS.202312-1077OC
Abstrakt: Rationale: Oral appliances are second-line treatments after continuous positive airway pressure for obstructive sleep apnea (OSA) management. However, the need for oral appliance titration limits their use as a result of monitoring challenges to assess the treatment effect on OSA. Objectives: To assess the validity of mandibular jaw movement (MJM) automated analysis compared with polysomnography (PSG) and polygraphy (PG) in evaluating the effect of oral appliance treatment and the effectiveness of MJM monitoring for oral appliance titration at home in patients with OSA. Methods: This observational, prospective study included 135 patients with OSA eligible for oral appliance therapy. The primary outcome was the apnea-hypopnea index (AHI), measured through in-laboratory PSG/PG and MJM-based technology. Additionally, MJM monitoring at home was conducted at regular intervals during the titration process. The agreement between PSG/PG and MJM automated analysis was revaluated using Bland-Altman analysis. Changes in AHI during the home-based oral appliance titration process were evaluated using a generalized linear mixed model and a generalized estimating equation model. Results: The automated MJM analysis demonstrated strong agreement with PG in assessing AHI at the end of titration, with a median bias of 0.24/h (limits of agreement, -11.2 to 12.8/h). The improvement of AHI from baseline in response to oral appliance treatment was consistent across three evaluation conditions: in-laboratory PG (-59.6%; 95% confidence interval, -59.8% to -59.5%), in-laboratory automated MJM analysis (-59.2%; -65.2% to -52.2%), and at-home automated MJM analysis (-59.7%; -67.4% to -50.2%). Conclusions: Incorporating MJM automated analysis into the oral appliance titration process has the potential to optimize oral appliance therapy outcomes for OSA.
Databáze: MEDLINE
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