Influence of mandibular advancement on tongue dilatory movement during wakefulness and how this is related to oral appliance therapy outcome for obstructive sleep apnea
Abstract Study Objectives To characterize how mandibular advancement splint (MAS) alters inspiratory tongue movement in people with obstructive sleep apnea (OSA) during wakefulness and whether this is associated with MAS treatment outcome. Methods A total of 87 untreated OSA participants (20 women,...
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| Veröffentlicht in: | Sleep (New York, N.Y.) N.Y.), 2021-03, Vol.44 (3), p.1 |
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| creator | Jugé, Lauriane Yeung, Jade Knapman, Fiona L Burke, Peter G R Lowth, Aimee B Gan, Ken Z C Brown, Elizabeth C Butler, Jane E Eckert, Danny J Ngiam, Joachim Sutherland, Kate Cistulli, Peter A Bilston, Lynne E |
| description | Abstract
Study Objectives
To characterize how mandibular advancement splint (MAS) alters inspiratory tongue movement in people with obstructive sleep apnea (OSA) during wakefulness and whether this is associated with MAS treatment outcome.
Methods
A total of 87 untreated OSA participants (20 women, apnea–hypopnea index (AHI) 7–102 events/h, aged 19–76 years) underwent a 3T MRI with a MAS in situ. Mid-sagittal tagged images quantified inspiratory tongue movement with the mandible in a neutral position and advanced to 70% of the maximum. Movement was quantified with harmonic phase methods. Treatment outcome was determined after at least 9 weeks of therapy.
Results
A total of 72 participants completed the study: 34 were responders (AHI < 5 or AHI ≤ 10events/h with >50% reduction in AHI), 9 were partial responders (>50% reduction in AHI but AHI > 10 events/h), and 29 nonresponders (change in AHI 1 mm) were partial or complete responders.
Conclusions
The mandibular advancement action on upper airway dilator muscles differs between individuals. When mandibular advancement alters inspiratory tongue movement, therapeutic response to MAS therapy was more common among those who convert to a beneficial movement pattern. |
| doi_str_mv | 10.1093/sleep/zsaa196 |
| format | Article |
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Study Objectives
To characterize how mandibular advancement splint (MAS) alters inspiratory tongue movement in people with obstructive sleep apnea (OSA) during wakefulness and whether this is associated with MAS treatment outcome.
Methods
A total of 87 untreated OSA participants (20 women, apnea–hypopnea index (AHI) 7–102 events/h, aged 19–76 years) underwent a 3T MRI with a MAS in situ. Mid-sagittal tagged images quantified inspiratory tongue movement with the mandible in a neutral position and advanced to 70% of the maximum. Movement was quantified with harmonic phase methods. Treatment outcome was determined after at least 9 weeks of therapy.
Results
A total of 72 participants completed the study: 34 were responders (AHI < 5 or AHI ≤ 10events/h with >50% reduction in AHI), 9 were partial responders (>50% reduction in AHI but AHI > 10 events/h), and 29 nonresponders (change in AHI <50% and AHI ≥ 10 events/h). About 62% (45/72) of participants had minimal inspiratory tongue movement (<1 mm) in the neutral position, and this increased to 72% (52/72) after advancing the mandible. Mandibular advancement altered inspiratory tongue movement pattern for 40% (29/72) of participants. When tongue dilatory patterns altered with advancement, 80% (4/5) of those who changed to a counterproductive movement pattern (posterior movement >1 mm) were nonresponders and 71% (5/7) of those who changed to beneficial (anterior movement >1 mm) were partial or complete responders.
Conclusions
The mandibular advancement action on upper airway dilator muscles differs between individuals. When mandibular advancement alters inspiratory tongue movement, therapeutic response to MAS therapy was more common among those who convert to a beneficial movement pattern.</description><identifier>ISSN: 0161-8105</identifier><identifier>EISSN: 1550-9109</identifier><identifier>DOI: 10.1093/sleep/zsaa196</identifier><identifier>PMID: 32954420</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Adult ; Aged ; Female ; Humans ; Mandibular Advancement ; Medical imaging equipment ; Middle Aged ; Patient outcomes ; Polysomnography ; Sleep apnea ; Sleep apnea syndromes ; Sleep Apnea, Obstructive - therapy ; Tongue - diagnostic imaging ; Treatment Outcome ; Wakefulness ; Young Adult</subject><ispartof>Sleep (New York, N.Y.), 2021-03, Vol.44 (3), p.1</ispartof><rights>Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com. 2020</rights><rights>Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.</rights><rights>COPYRIGHT 2021 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c460t-58682d889ebcef72880c7bd26811bc0d5b8cc8852bb667a3d92a3ca2af455c553</citedby><cites>FETCH-LOGICAL-c460t-58682d889ebcef72880c7bd26811bc0d5b8cc8852bb667a3d92a3ca2af455c553</cites><orcidid>0000-0001-8250-9019 ; 0000-0002-9705-2450 ; 0000-0002-7920-4924 ; 0000-0001-6106-7303 ; 0000-0003-0829-5934 ; 0000-0003-3503-2363</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32954420$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jugé, Lauriane</creatorcontrib><creatorcontrib>Yeung, Jade</creatorcontrib><creatorcontrib>Knapman, Fiona L</creatorcontrib><creatorcontrib>Burke, Peter G R</creatorcontrib><creatorcontrib>Lowth, Aimee B</creatorcontrib><creatorcontrib>Gan, Ken Z C</creatorcontrib><creatorcontrib>Brown, Elizabeth C</creatorcontrib><creatorcontrib>Butler, Jane E</creatorcontrib><creatorcontrib>Eckert, Danny J</creatorcontrib><creatorcontrib>Ngiam, Joachim</creatorcontrib><creatorcontrib>Sutherland, Kate</creatorcontrib><creatorcontrib>Cistulli, Peter A</creatorcontrib><creatorcontrib>Bilston, Lynne E</creatorcontrib><title>Influence of mandibular advancement on tongue dilatory movement during wakefulness and how this is related to oral appliance therapy outcome for obstructive sleep apnea</title><title>Sleep (New York, N.Y.)</title><addtitle>Sleep</addtitle><description>Abstract
Study Objectives
To characterize how mandibular advancement splint (MAS) alters inspiratory tongue movement in people with obstructive sleep apnea (OSA) during wakefulness and whether this is associated with MAS treatment outcome.
Methods
A total of 87 untreated OSA participants (20 women, apnea–hypopnea index (AHI) 7–102 events/h, aged 19–76 years) underwent a 3T MRI with a MAS in situ. Mid-sagittal tagged images quantified inspiratory tongue movement with the mandible in a neutral position and advanced to 70% of the maximum. Movement was quantified with harmonic phase methods. Treatment outcome was determined after at least 9 weeks of therapy.
Results
A total of 72 participants completed the study: 34 were responders (AHI < 5 or AHI ≤ 10events/h with >50% reduction in AHI), 9 were partial responders (>50% reduction in AHI but AHI > 10 events/h), and 29 nonresponders (change in AHI <50% and AHI ≥ 10 events/h). About 62% (45/72) of participants had minimal inspiratory tongue movement (<1 mm) in the neutral position, and this increased to 72% (52/72) after advancing the mandible. Mandibular advancement altered inspiratory tongue movement pattern for 40% (29/72) of participants. When tongue dilatory patterns altered with advancement, 80% (4/5) of those who changed to a counterproductive movement pattern (posterior movement >1 mm) were nonresponders and 71% (5/7) of those who changed to beneficial (anterior movement >1 mm) were partial or complete responders.
Conclusions
The mandibular advancement action on upper airway dilator muscles differs between individuals. When mandibular advancement alters inspiratory tongue movement, therapeutic response to MAS therapy was more common among those who convert to a beneficial movement pattern.</description><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Humans</subject><subject>Mandibular Advancement</subject><subject>Medical imaging equipment</subject><subject>Middle Aged</subject><subject>Patient outcomes</subject><subject>Polysomnography</subject><subject>Sleep apnea</subject><subject>Sleep apnea syndromes</subject><subject>Sleep Apnea, Obstructive - therapy</subject><subject>Tongue - diagnostic imaging</subject><subject>Treatment Outcome</subject><subject>Wakefulness</subject><subject>Young Adult</subject><issn>0161-8105</issn><issn>1550-9109</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFksFu1DAQhiMEokvhyBVZ4tJLWseJE-dYVS1UqsSlnKOJPd66OHaw462WJ-Ix8XYXKlAlZEuWZ77_94w1RfG-oqcV7euzaBHnsx8RoOrbF8Wq4pyWfU69LFa0aqtSVJQfFW9ivKf53vT16-KoZj1vGkZXxc9rp21CJ5F4TSZwyozJQiCgNpCjE7qFeEcW79YJiTIWFh-2ZPKbfU6lYNyaPMA31Mk6jJFkE3LnH8hyZyLJO2AWocoexAewBObZmp15JjDAvCU-LdJPSLQPxI9xCUkuZoPksbnMO4S3xSsNNuK7w3lcfL26vL34XN58-XR9cX5TyqalS8lFK5gSosdRou6YEFR2o2KtqKpRUsVHIaUQnI1j23ZQq55BLYGBbjiXnNfHxcnedw7-e8K4DJOJEq0Fhz7FgTVNfqjhXZvRj_-g9z4Fl6sbGG_rmouONU_UGiwOxmm_BJA70-G8o5TVvOY7r9NnqLwUTkZ6h9rk-F-Cci-QwccYUA9zMBOE7VDRYTcZw-PnDYfJyPyHQ7FpnFD9oX-PwlPjPs3_8foF57jGsQ</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Jugé, Lauriane</creator><creator>Yeung, Jade</creator><creator>Knapman, Fiona L</creator><creator>Burke, Peter G R</creator><creator>Lowth, Aimee B</creator><creator>Gan, Ken Z C</creator><creator>Brown, Elizabeth C</creator><creator>Butler, Jane E</creator><creator>Eckert, Danny J</creator><creator>Ngiam, Joachim</creator><creator>Sutherland, Kate</creator><creator>Cistulli, Peter A</creator><creator>Bilston, Lynne E</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8250-9019</orcidid><orcidid>https://orcid.org/0000-0002-9705-2450</orcidid><orcidid>https://orcid.org/0000-0002-7920-4924</orcidid><orcidid>https://orcid.org/0000-0001-6106-7303</orcidid><orcidid>https://orcid.org/0000-0003-0829-5934</orcidid><orcidid>https://orcid.org/0000-0003-3503-2363</orcidid></search><sort><creationdate>20210301</creationdate><title>Influence of mandibular advancement on tongue dilatory movement during wakefulness and how this is related to oral appliance therapy outcome for obstructive sleep apnea</title><author>Jugé, Lauriane ; Yeung, Jade ; Knapman, Fiona L ; Burke, Peter G R ; Lowth, Aimee B ; Gan, Ken Z C ; Brown, Elizabeth C ; Butler, Jane E ; Eckert, Danny J ; Ngiam, Joachim ; Sutherland, Kate ; Cistulli, Peter A ; Bilston, Lynne E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c460t-58682d889ebcef72880c7bd26811bc0d5b8cc8852bb667a3d92a3ca2af455c553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Humans</topic><topic>Mandibular Advancement</topic><topic>Medical imaging equipment</topic><topic>Middle Aged</topic><topic>Patient outcomes</topic><topic>Polysomnography</topic><topic>Sleep apnea</topic><topic>Sleep apnea syndromes</topic><topic>Sleep Apnea, Obstructive - therapy</topic><topic>Tongue - diagnostic imaging</topic><topic>Treatment Outcome</topic><topic>Wakefulness</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jugé, Lauriane</creatorcontrib><creatorcontrib>Yeung, Jade</creatorcontrib><creatorcontrib>Knapman, Fiona L</creatorcontrib><creatorcontrib>Burke, Peter G R</creatorcontrib><creatorcontrib>Lowth, Aimee B</creatorcontrib><creatorcontrib>Gan, Ken Z C</creatorcontrib><creatorcontrib>Brown, Elizabeth C</creatorcontrib><creatorcontrib>Butler, Jane E</creatorcontrib><creatorcontrib>Eckert, Danny J</creatorcontrib><creatorcontrib>Ngiam, Joachim</creatorcontrib><creatorcontrib>Sutherland, Kate</creatorcontrib><creatorcontrib>Cistulli, Peter A</creatorcontrib><creatorcontrib>Bilston, Lynne E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jugé, Lauriane</au><au>Yeung, Jade</au><au>Knapman, Fiona L</au><au>Burke, Peter G R</au><au>Lowth, Aimee B</au><au>Gan, Ken Z C</au><au>Brown, Elizabeth C</au><au>Butler, Jane E</au><au>Eckert, Danny J</au><au>Ngiam, Joachim</au><au>Sutherland, Kate</au><au>Cistulli, Peter A</au><au>Bilston, Lynne E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of mandibular advancement on tongue dilatory movement during wakefulness and how this is related to oral appliance therapy outcome for obstructive sleep apnea</atitle><jtitle>Sleep (New York, N.Y.)</jtitle><addtitle>Sleep</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>44</volume><issue>3</issue><spage>1</spage><pages>1-</pages><issn>0161-8105</issn><eissn>1550-9109</eissn><abstract>Abstract
Study Objectives
To characterize how mandibular advancement splint (MAS) alters inspiratory tongue movement in people with obstructive sleep apnea (OSA) during wakefulness and whether this is associated with MAS treatment outcome.
Methods
A total of 87 untreated OSA participants (20 women, apnea–hypopnea index (AHI) 7–102 events/h, aged 19–76 years) underwent a 3T MRI with a MAS in situ. Mid-sagittal tagged images quantified inspiratory tongue movement with the mandible in a neutral position and advanced to 70% of the maximum. Movement was quantified with harmonic phase methods. Treatment outcome was determined after at least 9 weeks of therapy.
Results
A total of 72 participants completed the study: 34 were responders (AHI < 5 or AHI ≤ 10events/h with >50% reduction in AHI), 9 were partial responders (>50% reduction in AHI but AHI > 10 events/h), and 29 nonresponders (change in AHI <50% and AHI ≥ 10 events/h). About 62% (45/72) of participants had minimal inspiratory tongue movement (<1 mm) in the neutral position, and this increased to 72% (52/72) after advancing the mandible. Mandibular advancement altered inspiratory tongue movement pattern for 40% (29/72) of participants. When tongue dilatory patterns altered with advancement, 80% (4/5) of those who changed to a counterproductive movement pattern (posterior movement >1 mm) were nonresponders and 71% (5/7) of those who changed to beneficial (anterior movement >1 mm) were partial or complete responders.
Conclusions
The mandibular advancement action on upper airway dilator muscles differs between individuals. When mandibular advancement alters inspiratory tongue movement, therapeutic response to MAS therapy was more common among those who convert to a beneficial movement pattern.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>32954420</pmid><doi>10.1093/sleep/zsaa196</doi><orcidid>https://orcid.org/0000-0001-8250-9019</orcidid><orcidid>https://orcid.org/0000-0002-9705-2450</orcidid><orcidid>https://orcid.org/0000-0002-7920-4924</orcidid><orcidid>https://orcid.org/0000-0001-6106-7303</orcidid><orcidid>https://orcid.org/0000-0003-0829-5934</orcidid><orcidid>https://orcid.org/0000-0003-3503-2363</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0161-8105 |
| ispartof | Sleep (New York, N.Y.), 2021-03, Vol.44 (3), p.1 |
| issn | 0161-8105 1550-9109 |
| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Female Humans Mandibular Advancement Medical imaging equipment Middle Aged Patient outcomes Polysomnography Sleep apnea Sleep apnea syndromes Sleep Apnea, Obstructive - therapy Tongue - diagnostic imaging Treatment Outcome Wakefulness Young Adult |
| title | Influence of mandibular advancement on tongue dilatory movement during wakefulness and how this is related to oral appliance therapy outcome for obstructive sleep apnea |
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