The effects of mandibular advancement appliance therapy on the sequence of jaw-closing muscle activity and respiratory events in individuals with obstructive sleep apnea

Sleep and Breathing - Tập 27 Số 2 - Trang 757-764 - 2023
Deshui Li1, Ghizlane Aarab1, Frank Lobbezoo1, Patrick Arcache2, Gilles Lavigne2, Nelly Huynh2
1Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
2Faculté de Médicine Dentaire, Université de Montréal, Montreal, Canada

Tóm tắt

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.

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Tài liệu tham khảo

Redline S (2005) Obstructive sleep apnea: phenotypes and genetics. In: Kryger MH, Roth T, Dement WC (eds) Principles and practice of sleep medicine, Sixth edit. Elsevier, Philadelphia, PA, pp 1102–1109

Semelka M, Wilson J, Floyd R (2016) Diagnosis and treatment of obstructive sleep apnea in adults. Am Fam Physician 94:355–360. https://doi.org/10.1037/e676562012-001

Senaratna CV, Perret JL, Lodge CJ et al (2017) Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 34:70–81. https://doi.org/10.1016/j.smrv.2016.07.002

Jordan AS, McSharry DG, Malhotra A (2014) Adult obstructive sleep apnoea. Lancet 383:736–747

Ohayon MM, Li KK, Guilleminault C (2001) Risk factors for sleep bruxism in the general population. Chest 119:53–61. https://doi.org/10.1378/chest.119.1.53

Kato T, Masuda Y, Yoshida A, Morimoto T (2011) Masseter EMG activity during sleep and sleep bruxism. Arch Ital Biol 149:478–491. https://doi.org/10.4449/aib.v149i4.1317

Hollowell DE, Suratt PM (1989) Activation of masseter muscles with inspiratory resistance loading. J Appl Physiol 67:270–275. https://doi.org/10.1152/jappl.1989.67.1.270

Hollowell DE, Suratt PM (1991) Mandible position and activation of submental and masseter muscles during sleep. J Appl Physiol 71:2267–2273. https://doi.org/10.1152/jappl.1991.71.6.2267

da Costa Lopes AJ, Cunha TCA, Monteiro MCM et al (2020) Is there an association between sleep bruxism and obstructive sleep apnea syndrome? A systematic review. Sleep Breath 24:913–921. https://doi.org/10.1007/s11325-019-01919-y

Lavigne GJ, Huynh N, Kato T et al (2007) Genesis of sleep bruxism: motor and autonomic-cardiac interactions. Arch Oral Biol 52:381–384. https://doi.org/10.1016/j.archoralbio.2006.11.017

Saito M, Yamaguchi T, Mikami S et al (2014) Temporal association between sleep apnea-hypopnea and sleep bruxism events. J Sleep Res 23:196–203. https://doi.org/10.1111/jsr.12099

Okeson JP, Phillips BA, Berry DT et al (1991) Nocturnal bruxing events in subjects with sleep-disordered breathing and control subjects. J Craniomandib Disord 5:258–264

Manfredini D, Guarda-Nardini L, Marchese-Ragona R, Lobbezoo F (2015) Theories on possible temporal relationships between sleep bruxism and obstructive sleep apnea events. An expert opinion Sleep Breath 19:1459–1465. https://doi.org/10.1007/s11325-015-1163-5

Sjöholm TT, Lowe AA, Miyamoto K et al (2000) Sleep bruxism in patients with sleep-disordered breathing. Arch Oral Biol 45:889–896. https://doi.org/10.1016/S0003-9969(00)00044-3

Tsujisaka A, Haraki S, Nonoue S et al (2018) The occurrence of respiratory events in young subjects with a frequent rhythmic masticatory muscle activity: a pilot study. J Prosthodont Res 62:317–323. https://doi.org/10.1016/j.jpor.2017.12.004

Kato T, Rompré P, Montplaisir JY et al (2001) Sleep bruxism: an oromotor activity secondary to micro-arousal. J Dent Res 80:1940–1944. https://doi.org/10.1177/00220345010800101501

Carra MC, Rompré PH, Kato T et al (2011) Sleep bruxism and sleep arousal: an experimental challenge to assess the role of cyclic alternating pattern. J Oral Rehabil 38:635–642. https://doi.org/10.1111/j.1365-2842.2011.02203.x

Huynh N, Kato T, Rompré PH et al (2006) Sleep bruxism is associated to micro-arousals and an increase in cardiac sympathetic activity. J Sleep Res 15:339–346. https://doi.org/10.1111/j.1365-2869.2006.00536.x

Aarab G, Arcache P, Lavigne GJ et al (2020) The effects of mandibular advancement appliance therapy on jaw-closing muscle activity during sleep in patients with obstructive sleep apnea: a 3–6 months follow-up. J Clin Sleep Med 16:1545–1553. https://doi.org/10.5664/jcsm.8612

Berry RB, Budhiraja R, Gottlieb DJ et al (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. J Clin Sleep Med 8:597–619. https://doi.org/10.5664/jcsm.2172

Carra MC, Huynh N, Lavigne GJ (2015) Diagnostic accuracy of sleep bruxism scoring in absence of audio-video recording: a pilot study. Sleep Breath 19:183–190. https://doi.org/10.1007/s11325-014-0986-9

Hosoya H, Kitaura H, Hashimoto T et al (2014) Relationship between sleep bruxism and sleep respiratory events in patients with obstructive sleep apnea syndrome. Sleep Breath 18:837–844. https://doi.org/10.1007/s11325-014-0953-5

Simms T, Brijbassi M, Montemurro LT, Bradley TD (2013) Differential timing of arousals in obstructive and central sleep apnea in patients with heart failure. J Clin Sleep Med 9:773–779. https://doi.org/10.5664/jcsm.2918

Schwartz DJ, Moxley P, Barker A, Longman M (2005) On a characteristic of cortical arousals in individuals with obstructive sleep apnea.

Kato T, Katase T, Yamashita S et al (2013) Responsiveness of jaw motor activation to arousals during sleep in patients with obstructive sleep apnea syndrome. J Clin Sleep Med 9:759–765. https://doi.org/10.5664/jcsm.2914

Barnes M, McEvoy RD, Banks S et al (2004) Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med 170:656–664. https://doi.org/10.1164/rccm.200311-1571OC

Bloch KE, Iseli A, Zhang JN et al (2000) A randomized controlled crossover trial of two oral appliances for sleep apnea treatment. Am J Respir Crit Care Med 162:246–251. https://doi.org/10.1164/ajrccm.162.1.9908112

Landry M-L, Rompré PH, Manzini C et al (2006) Reduction of sleep bruxism using a mandibular advancement device: an experimental controlled study. Int J Prosthodont 19:549–556

Landry-Schönbeck A, de Grandmont P, Rompré PH, Lavigne GJ (2009) Effect of an adjustable mandibular advancement appliance on sleep bruxism: a crossover sleep laboratory study. Int J Prosthodont 22:251–259

Lavigne GJ, Rompré PH, Poirier G et al (2001) Rhythmic masticatory muscle activity during sleep in humans. J Dent Res 80:443–448. https://doi.org/10.1177/00220345010800020801