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A3974 - Sleep Mandibular Movements Recording Can Be Used for Mandibular Advancement Device Titration
Author Block: B. Melki1, J. Martinot2, N. Le Dong3, J. Borel4, V. Cuthbert2, J. Pépin5; 1University Grenoble Alpes, Grenoble, France, Grenoble, France, 2CHU UCL Namur, Namur, Belgium, 3RespiSom, Erpent, Belgium, 4Sleep Laboratory, University Grenoble Alpes, Grenoble, France, 5Laboratoire EFCR, University Grenoble Alpes, Grenoble, France.
""Rationale: The vertical peak-to-peak respiratory displacement of the mandible (MM) is an accurate marker of respiratory events and micro-arousals during sleep disordered breathing (SDB). However, it’s still unknown whether MM could be altered under treatment with Mandibular advancement devices (MAD). In this prospective study, we evaluated the effects of MAD therapy on MM derived respiratory disorders events, in comparison with conventional indices (AHI and ODI). Methods: In 25 middle to moderate OSA patients (median age=44.3) treated with MAD, MM derived respiratory disorders events rate (MMRDI, in n/h) along with AHI and ODI were recorded before the treatment by type-2 and after MAD titration by type-3 polygraph incorporating each a magnetometer that captures MM. The effect of MAD on each outcome was evaluated using a Bayesian multilevel negative-binomial model. Results: Before MAD treatment, median of MMRDI, AHI and ODI were respectively 18.2, 14.8 and 7.6 (events/hour). MAD significantly improved all 3 outcomes by an incidence rate change of -70.9% (95 CI:-57.6 to -80.3) for AHI, -68.8% (95 CI:-44.9 to -82.4) for ODI and -73.9% (95 CI:-62 to 82.1) for MMRDI. Bayesian inferences indicate that the effect size of MAD (improvement from baseline) on MMRDI was non different to that on AHI and greater than that on ODI. Conclusion: MAD treatment reduces MM derived respiratory disorders events in the same proportion of classical AHI; MAD titration can be performed by monitoring at home the vertical respiratory movement of the mandible.