The key role of the mandible in modulating airflow amplitude during sleep

Respir Physiol Neurobiol. 2020 Aug:279:103447. doi: 10.1016/j.resp.2020.103447. Epub 2020 May 13.

Abstract

Rationale: Mandibular position and motion during sleep rely on the balance between mandibular elevators and depressors. We hypothesized that vertical mandibular position (VMP) modulates airflow amplitude during sleep.

Methods: VMP, tidal nasal flow pressure (NFP) and concurrent surface electromyographic activity of the masseters (sEMG-m) were recorded and processed by a customized algorithm from 100 polysomnographic fragments including a micro-arousal (25 obstructive sleep apnea patients). The relationship between mandibular position and changes in airflow was analysed.

Result: Concurrent VMP and sEMG-m activity changes routinely occurred before a new steady state of airflow documented by NFP. Vertical mandible depression was associated with a median (95% CI) reduction in NFP of 40.9% (14.6%-71.3%, p = 0.007) while vertical mandible elevation and mouth closure were associated with a median (95% CI) relative increase in NFP after arousal of 52.6% (17.9%-56.2%, p = 0.001).

Conclusion: Elevation and lowering of the mandible were associated with changes in masseteric EMG activity modulating airflow amplitude during sleep.

Keywords: Dental appliance; Mandibular movements; Mouth opening; Sleep apnea syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Electromyography
  • Female
  • Humans
  • Male
  • Mandible / physiology*
  • Mandible / physiopathology
  • Masticatory Muscles / physiology*
  • Masticatory Muscles / physiopathology
  • Middle Aged
  • Occlusal Splints*
  • Pharyngeal Muscles / physiology*
  • Pharyngeal Muscles / physiopathology
  • Polysomnography
  • Prospective Studies
  • Respiratory Mechanics / physiology*
  • Sleep / physiology
  • Sleep Apnea, Obstructive / physiopathology*
  • Sleep Apnea, Obstructive / rehabilitation