Cardiopulmonary Coupling Analysis: Changes before and after Treatment with a Mandibular Advancement Device

Abstract

Objectives: Evaluate the changes of sleep quality in patients using a mandibular advancement device (MAD) for obstructive sleep apnea (OSA) based upon cardiopulmonary coupling (CPC). Methods: A total of 52 patients (mean age, 53.7 ± 9.6 years; range, 33-74 years) were included in this study. Of them, there were 47 males (90.4%). All subjects were diagnosed with OSA after in-laboratory full-night polysomnography and re-evaluated after 3-month use of a MAD. At baseline, apnea-hypopnea index (AHI) was 33.6 ± 17.0. We compared CPC parameters at baseline with those after 3 month use of a MAD. Results: Low frequency coupling (59.5 ± 16.1 to 47.7 ± 14.8%, P < .001) and elevated low frequency coupling (44.6 ± 18.4 to 32.6 ± 15.7%, P < .001) significantly decreased. High frequency coupling (28.6 ± 16.0 to 36.5 ± 15.7%, P = .004) and very low frequency coupling (11.7 ± 7.2 to 15.3 ± 6.6%, P = .028) significantly increased. The change of AHI significantly correlated with changes of the CPC parameters: negatively correlated with high frequency coupling change ( r = –0.572, P < .001); positively correlated with low frequency and elevated low frequency coupling changes ( r = 0.604 and 0.497, respectively; P < .001 in both). Conclusions: Low frequency coupling decreased as AHI improved while high frequency coupling increased as AHI improved. The CPC parameters showed that the sleep quality was improved by MAD therapy.