Dose-dependent Effects of Mandibular Advancement on Upper Airway Collapsibility and Muscle Function in Obstructive Sleep Apnea

Sleep
Ahmad A BamagoosDanny J Eckert

Abstract

Mandibular Advancement Splints (MAS) are the leading treatment alternative to CPAP for OSA. However, not all patients experience clinical benefit and treatment prediction remains challenging. Understanding the effects of mandibular advancement on pharyngeal collapsibility and muscle function may provide valuable information on the mechanisms of MAS, and thereby help to develop novel approaches for patient selection. Thus, we aimed to determine dose-dependent effects of mandibular advancement on pharyngeal collapsibility and muscle function concurrently in OSA patients undergoing MAS therapy. Twelve (11 male) MAS-naïve patients underwent a detailed physiology sleep study (polysomnography) to quantify pharyngeal collapsibility (PCRIT), pharyngeal muscle responsiveness to negative pharyngeal pressure (via genioglossus intramuscular electromyography and an epiglottic pressure sensor) and effectiveness to restore airflow and minute ventilation after 1-minute transient CPAP reductions (induced airflow-limitation) at three mandibular advancement positions: 0% (habitual bite), 50% and 100% of the maximum comfortable mandibular advancement. Standard clinical polysomnography after MAS therapy optimization was performed to determine treat...Continue Reading

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Citations

Aug 10, 2019·Annals of the American Thoracic Society·Ahmad A BamagoosScott A Sands
Oct 31, 2019·Expert Review of Respiratory Medicine·Andrew S L ChanPeter A Cistulli
Dec 8, 2019·Journal of Clinical Medicine·Kate Sutherland, Peter A Cistulli
Feb 1, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Benjamin K TongDanny J Eckert
May 13, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Yanyan MaXuemei Gao
Jul 6, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Marcello BosiGiulio Alessandri-Bonetti
Nov 9, 2019·Journal of Dental Research·G J LavigneP A Cistulli
Jul 6, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Eugenio De CorsoEmanuele Scarano
Sep 27, 2019·European Respiratory Review : an Official Journal of the European Respiratory Society·Marie MarklundJohan Verbraecken
Nov 11, 2020·Pulmonary Therapy·Claire E Francis, Tim Quinnell
Jan 25, 2021·Sleep Medicine Clinics·Kate SutherlandPeter A Cistulli
Oct 29, 2021·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Ritaban DuttaDanny J Eckert

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