Mandibular movement monitoring may help improve oral sleep apnoea devices…….

NAMUR, Belgium: To date, continuous positive airway pressure is still the industry standard when it comes to treating sleep apnoea. However, the cumbersome machines are not well tolerated by patients. In a new study, researchers have demonstrated that mandibular movement (MM) monitoring can be used to assess the efficacy of other oral devices.

In the study, 56 patients with obstructive sleep apnoea (OSA) were fitted with a custom mandibular advancement splint (oral appliance therapy) and had their midsagittal MM tracked. Patients were evaluated at the end of the titration procedure. During the titration procedure, different degrees of advancement are trialled up and down to find the single best amount to control apnoea events for the particular patient.

Lead investigator Dr Jean-Benoît Martinot, from the Sleep Laboratory at the Sainte-Elisabeth site of the UCLouvain Namur teaching hospital, explained that the novelty of the study was tracking sleep MM in order to assess the effectiveness of oral appliance therapy (OAT). “Our study suggested for the first time that MM monitoring represents a powerful tool for assessing the efficacy of OAT,” he continued.

According to the study’s results, by the end of titration, all indications of OSA had decreased compared with the initial baseline. Overall, patients also showed a reduction of vertical respiratory MM and sleep respiratory effort, as well as a dramatic decrease in obstructive hypopnoea. Scores from the apnoea–hypopnoea index and oxygen desaturation index also dropped, and the researchers found that MM monitoring also helped reveal the presence of central apnoeas.

With new technology on the horizon, the researchers believe that 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,” commented Martinot.

The study, titled “Mandibular movement analysis to assess efficacy of oral appliance therapy in OSA”, was published online on 6 November 2018 in Chest ahead of inclusion in an issue.