Mandibular Movements As Accurate Reporters of Respiratory Effort during Sleep: Validation against Diaphragmatic Electromyography
ContextMandibular movements (MM) are considered as reliable reporters of respiratory effort (RE) during sleep and sleep disordered breathing (SDB), but MM accuracy has never been validated against the gold standard diaphragmatic electromyography (EMG-d).ObjectivesTo assess the degree of agreement be...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2017-07-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/article/10.3389/fneur.2017.00353/full |
| _version_ | 1818534830320648192 |
|---|---|
| author | Jean-Benoît Martinot Nhat-Nam Le-Dong Valerie Cuthbert Stephane Denison Philip E. Silkoff Hervé Guénard David Gozal Jean-Louis Pepin Jean-Louis Pepin Jean-Christian Borel Jean-Christian Borel |
| author_facet | Jean-Benoît Martinot Nhat-Nam Le-Dong Valerie Cuthbert Stephane Denison Philip E. Silkoff Hervé Guénard David Gozal Jean-Louis Pepin Jean-Louis Pepin Jean-Christian Borel Jean-Christian Borel |
| author_sort | Jean-Benoît Martinot |
| collection | DOAJ |
| description | ContextMandibular movements (MM) are considered as reliable reporters of respiratory effort (RE) during sleep and sleep disordered breathing (SDB), but MM accuracy has never been validated against the gold standard diaphragmatic electromyography (EMG-d).ObjectivesTo assess the degree of agreement between MM and EMG-d signals during different sleep stages and abnormal respiratory events.MethodsTwenty-five consecutive adult patients with SDB were studied by polysomnography (PSG) that also included multipair esophageal diaphragm electromyography and a magnetometer to record MM. EMG-d activity (microvolt) and MM (millimeter) amplitudes were extracted by envelope processing. Agreement between signals amplitudes was evaluated by mixed linear regression and cross-correlation function and in segments of PSG including event-free and SDB periods.ResultsThe average total sleep time was 370 ± 18 min and the apnea hypopnea index was 24.8 ± 5.2 events/h. MM and EMG-d amplitudes were significantly cross-correlated: median r (95% CI): 0.67 (0.23–0.96). A mixed linear model showed that for each 10 µV of increase in EMG-d activity, MM amplitude increased by 0.28 mm. The variations in MM amplitudes (median range: 0.11–0.84 mm) between normal breathing, respiratory effort-related arousal, obstructive, mixed, and central apnea periods closely corresponded to those observed with EMG-d activity (median range: 2.11–8.23 µV).ConclusionMM amplitudes change proportionally to diaphragmatic EMG activity and accurately identify variations of RE during normal sleep and SDB. |
| first_indexed | 2024-12-11T18:16:42Z |
| format | Article |
| id | doaj.art-ddd2e22e168942b6bb55020c929839b2 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T18:16:42Z |
| publishDate | 2017-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-ddd2e22e168942b6bb55020c929839b22022-12-22T00:55:25ZengFrontiers Media S.A.Frontiers in Neurology1664-22952017-07-01810.3389/fneur.2017.00353281508Mandibular Movements As Accurate Reporters of Respiratory Effort during Sleep: Validation against Diaphragmatic ElectromyographyJean-Benoît Martinot0Nhat-Nam Le-Dong1Valerie Cuthbert2Stephane Denison3Philip E. Silkoff4Hervé Guénard5David Gozal6Jean-Louis Pepin7Jean-Louis Pepin8Jean-Christian Borel9Jean-Christian Borel10CHU UCL Namur, Namur, BelgiumRespiSom, Erpent, BelgiumCHU UCL Namur, Namur, BelgiumCHU UCL Namur, Namur, BelgiumPenn Valley, Allentown, PA, United StatesUniversité and CHU de Bordeaux, Bordeaux, FranceUniversity of Chicago, Chicago, IL, United StatesCHU de Grenoble, Laboratoire EFCR, Pôle Thorax et Vaisseaux, Grenoble, FranceUniversity Grenoble Alps, HP2 INSERM U1042, Grenoble, FranceUniversity Grenoble Alps, HP2 INSERM U1042, Grenoble, FranceAGIR à dom. Association, Meylan, FranceContextMandibular movements (MM) are considered as reliable reporters of respiratory effort (RE) during sleep and sleep disordered breathing (SDB), but MM accuracy has never been validated against the gold standard diaphragmatic electromyography (EMG-d).ObjectivesTo assess the degree of agreement between MM and EMG-d signals during different sleep stages and abnormal respiratory events.MethodsTwenty-five consecutive adult patients with SDB were studied by polysomnography (PSG) that also included multipair esophageal diaphragm electromyography and a magnetometer to record MM. EMG-d activity (microvolt) and MM (millimeter) amplitudes were extracted by envelope processing. Agreement between signals amplitudes was evaluated by mixed linear regression and cross-correlation function and in segments of PSG including event-free and SDB periods.ResultsThe average total sleep time was 370 ± 18 min and the apnea hypopnea index was 24.8 ± 5.2 events/h. MM and EMG-d amplitudes were significantly cross-correlated: median r (95% CI): 0.67 (0.23–0.96). A mixed linear model showed that for each 10 µV of increase in EMG-d activity, MM amplitude increased by 0.28 mm. The variations in MM amplitudes (median range: 0.11–0.84 mm) between normal breathing, respiratory effort-related arousal, obstructive, mixed, and central apnea periods closely corresponded to those observed with EMG-d activity (median range: 2.11–8.23 µV).ConclusionMM amplitudes change proportionally to diaphragmatic EMG activity and accurately identify variations of RE during normal sleep and SDB.http://journal.frontiersin.org/article/10.3389/fneur.2017.00353/fullobstructive sleep apnearespiratory effortmandibular movementspolysomnographydiaphragm electromyography |
| spellingShingle | Jean-Benoît Martinot Nhat-Nam Le-Dong Valerie Cuthbert Stephane Denison Philip E. Silkoff Hervé Guénard David Gozal Jean-Louis Pepin Jean-Louis Pepin Jean-Christian Borel Jean-Christian Borel Mandibular Movements As Accurate Reporters of Respiratory Effort during Sleep: Validation against Diaphragmatic Electromyography Frontiers in Neurology obstructive sleep apnea respiratory effort mandibular movements polysomnography diaphragm electromyography |
| title | Mandibular Movements As Accurate Reporters of Respiratory Effort during Sleep: Validation against Diaphragmatic Electromyography |
| title_full | Mandibular Movements As Accurate Reporters of Respiratory Effort during Sleep: Validation against Diaphragmatic Electromyography |
| title_fullStr | Mandibular Movements As Accurate Reporters of Respiratory Effort during Sleep: Validation against Diaphragmatic Electromyography |
| title_full_unstemmed | Mandibular Movements As Accurate Reporters of Respiratory Effort during Sleep: Validation against Diaphragmatic Electromyography |
| title_short | Mandibular Movements As Accurate Reporters of Respiratory Effort during Sleep: Validation against Diaphragmatic Electromyography |
| title_sort | mandibular movements as accurate reporters of respiratory effort during sleep validation against diaphragmatic electromyography |
| topic | obstructive sleep apnea respiratory effort mandibular movements polysomnography diaphragm electromyography |
| url | http://journal.frontiersin.org/article/10.3389/fneur.2017.00353/full |
| work_keys_str_mv | AT jeanbenoitmartinot mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT nhatnamledong mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT valeriecuthbert mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT stephanedenison mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT philipesilkoff mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT herveguenard mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT davidgozal mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT jeanlouispepin mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT jeanlouispepin mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT jeanchristianborel mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography AT jeanchristianborel mandibularmovementsasaccuratereportersofrespiratoryeffortduringsleepvalidationagainstdiaphragmaticelectromyography |