Abstract
Context: Mandibular movements (MM) during sleep disordered breathing (SDB) are considered as related to the intensity of respiratory effort (RE). However this relationship has never been objectively documented by assessing RE with crural diaphragmatic EMG activity (EMGd). Objective: To assess the link between the MM and EMGd signals during sleep. Methods: 25 consecutive patients with SDB were explored during a type 2 PSG including a magnetometer (Brizzy®Nomics, BE) and an Edi-catheter (Getinge, SWE) to record MM and EMGd, respectively. The PSG scoring was performed according to AASM-2012 rules. Peak to peak distance of MM (MMd, expressed in 1/10mm) and EMGd (in mV) were extracted by envelope processing. Preliminary analysis showed a strong cross-correlation between both signals. A dataset of 14000 randomized, equal segments were used for fitting mixed linear model. Results: Patients characteristics were: Age= 49.8±12.5 yrs; BMI =30.2±6.6 kg/m2; TST=370±61.6min and AHI=24.8 ± 27.5 events/hour. There was a significant strong relationship between MMd and EMGd (MMd ~ 0.01 EMGd; p Pairwise comparisons indicated significant differences in MMd between Normal breathing and RE events, including RERA, Obstructive, Mixed and Central Apneas. Conclusion: Peak to peak Mandibular Movements change in proportion to crural diaphragmatic EMG, and allow identifying RE during sleep.
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