[en] 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.
Research Center/Unit :
d‐BRU - Dental Biomaterials Research Unit - ULiège
Disciplines :
Human health sciences: Multidisciplinary, general & others
Author, co-author :
Pépin, Jean-Louis ; 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, Peter A ; 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, Etienne ; Laboratoire du sommeil, Centre Hospitalier Universitaire (CHU) Université catholique de Louvain (UCL), Site Sainte-Elisabeth, Namur, Belgium
Tamisier, Renaud ; 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, Sébastien ; 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, Annick ; Université de Liège - ULiège > Dental biomaterials research unit (d-BRU)
Le-Dong, Nhat-Nam ; Sunrise, Namur, Belgium
Lavigne, Gilles ; 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, Atul ; University of California, San Diego, La Jolla, California, and
Martinot, Jean-Benoît ; 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
Language :
English
Title :
Mandibular Jaw Movement Automated Analysis for Oral Appliance Monitoring in Obstructive Sleep Apnea: A Prospective Cohort Study.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0. For commercial usage and reprints, please e-mail Diane Gern. Supported by the National Institutes of Health (A.M.), Canadian Institutes of Health Research Network for Canadian Oral Health Research (G.L.), Agence Nationale de la Recherche in the framework of the \u201CInvestissements d\u2019avenir\u201D program (ANR-15-IDEX-02), the \u201Ce-health and integrated care and trajectories medicine and MIAI artificial intelligence\u201D chairs of excellence from the Grenoble Alpes University Foundation (J.-L.P.), and MIAI Grenoble Alpes (ANR-19-P3IA-0003). Author Contributions: J.-L.P., J.-B.M., and N.-N.L.-D. designed the study. J.-L.P., J.-B.M., and E.C. conducted the research procedure and had full access to all study data. J.-L.P., J.-B.M., N.-N.L.-D., R.T., and S.B. performed data analysis. J.-L.P., J.-B.M., P.A.C., G.L., A.B., and A.M. have personally reviewed the data, verified the statistical methods employed for all analyses, and confirms an understanding of these analyses, that the methods are clearly described and that they are a fair way to report the results. J.-L.P., J.-B.M., and N.-N.L.-D. prepared the first draft of the manuscript. G.L., P.A.C., and A.B. reviewed and edited the final manuscript. All authors made the decision to submit the manuscript for publication and assume responsibility for the accuracy and completeness of the analyses and for the fidelity of this report to the study protocol.
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