Sleep Medicine
Volume 7, Issue 4 , Pages 368-373 , June 2006

Effects of mandibular advancement on upper airway dynamics in awake normal subjects: A pilot study with phrenic nerve stimulation

  • Eric Verin

      Affiliations

    • Service de Physiologie, CHU de Rouen, Rouen, France
    • GRHV EA 3830, Université de Rouen, Rouen, France
    • ,
  • Boris Petelle

      Affiliations

    • Service d'ORL et Chirurgie Cervico-Faciale, CHU Saint Antoine, Assistance Publique Hôpitaux de Paris, Paris, France
    • ,
  • Mathieu Raux

      Affiliations

    • UPRES EA 2397, Université Paris VI Pierre et Marie Curie, Paris, France
    • ,
  • Gérard Vincent

      Affiliations

    • Centre dentaire SM Colomb, Paris, France
    • ,
  • Bernard Fleury

      Affiliations

    • Centre d'Evaluation et de Traitement des Troubles du Sommeil, Service de Pneumologie, CHU Saint Antoine, Assistance Publique Hôpitaux de Paris, Paris, France
    • ,
  • Thomas Similowski

      Affiliations

    • UPRES EA 2397, Université Paris VI Pierre et Marie Curie, Paris, France
    • Service de Pneumologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique—Hôpitaux de Paris, Paris, France
    • Corresponding Author InformationCorresponding author. Address: Service de Pneumologie et Réanimation, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Bd de l'Hôpital, 75651 Paris Cedex 13, France. Tel.: +33 1 42176797; fax: 33 1 42176708.

Received 12 July 2005 ,Revised 30 September 2005 ,Accepted 5 November 2005.

References 

  1. Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med. 1976;27:465–484
  2. Remmers JE, deGroot WJ, Sauerland EK, Anch AM. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol. 1978;44:931–938
  3. Verin E, Similowski T, Series F. Effects of continuous positive airway pressure on upper airway inspiratory dynamics in awake patients with sleep-disordered breathing. J Physiol. 2003;546:279–287
  4. Sanders MH, Nasal CPAP. Nasal CPAP effect on patterns of sleep apnea. Chest. 1984;86:839–844
  5. Lamphere J, Roehrs T, Wittig R, et al. Recovery of alertness after CPAP in apnea. Chest. 1989;96:1364–1367
  6. Derderian SS, Bridenbaugh RH, Rajagopal KR. Neuropsychologic symptoms in obstructive sleep apnea improve after treatment with nasal continuous positive airway pressure. Chest. 1988;94:1023–1027
  7. Clark GT, Arand D, Chung E, Tong D. Effect of anterior mandibular positioning on obstructive sleep apnea. Am Rev Respir Dis. 1993;147:624–629
  8. Isono S, Tanaka A, Sho Y, Konno A, Nishino T. Advancement of the mandible improves velopharyngeal airway patency. J Appl Physiol. 1995;79:2132–2138
  9. Kato J, Isono S, Tanaka A, et al. Dose-dependent effects of mandibular advancement on pharyngeal mechanics and nocturnal oxygenation in patients with sleep-disordered breathing. Chest. 2000;117:1065–1072
  10. Series F, Demoule A, Marc I, et al. Inspiratory flow dynamics during phrenic nerve stimulation in awake normals during nasal breathing. Am J Respir Crit Care Med. 1999;160:614–620
  11. Series F, Straus C, Demoule A, et al. Assessment of upper airway dynamics in awake patients with sleep apnea using phrenic nerve stimulation. Am J Respir Crit Care Med. 2000;162:795–800
  12. Mills GH, Kyroussis D, Hamnegard CH, et al. Bilateral magnetic stimulation of the phrenic nerves from an anterolateral approach. Am J Respir Crit Care Med. 1996;154:1099–1105
  13. Verin E, Series F, Locher C, et al. Effects of neck flexion and mouth opening on inspiratory flow dynamics in awake humans. J Appl Physiol. 2002;92:84–92
  14. Series F, Verin E, Similowski T. Impediment in upper airway stabilizing forces assessed by phrenic nerve stimulation in sleep apnea patients. Respir Res. 2005;6:99
  15. Hudgel DW, Harasick T. Fluctuation in timing of upper airway and chest wall inspiratory muscle activity in obstructive sleep apnea. J Appl Physiol. 1990;69:443–450
  16. Verin E, Similowski T, Teixeira A, Series F. Discriminative power of phrenic twitch-induced dynamic response for diagnosis of sleep apnea during wakefulness. J Appl Physiol. 2003;94:31–37
  17. Hudgel DW. Variable site of airway narrowing among obstructive sleep apnea patients. J Appl Physiol. 1986;61:1403–1409
  18. Skatrud JB, Dempsey JA. Airway resistance and respiratory muscle function in snorers during NREM sleep. J Appl Physiol. 1985;59:328–335
  19. Schwartz AR, Smith PL, Wise RA, Gold AR, Permutt S. Induction of upper airway occlusion in sleeping individuals with subatmospheric nasal pressure. J Appl Physiol. 1988;64:535–542
  20. Schwartz AR, Smith PL, Wise RA, Bankman I, Permutt S. Effect of positive nasal pressure on upper airway pressure–flow relationships. J Appl Physiol. 1989;66:1626–1634
  21. Fleury B, Rakotonanahary D, Petelle B, et al. Mandibular advancement titration for obstructive sleep apnea: optimization of the procedure by combining clinical and oximetric parameters. Chest. 2004;125:1761–1767
  22. Petelle B, Vincent G, Gagnadoux F, et al. One-night mandibular advancement titration for obstructive sleep apnea syndrome: a pilot study. Am J Respir Crit Care Med. 2002;165:1150–1153

PII: S1389-9457(05)00267-4

doi: 10.1016/j.sleep.2005.11.002

Sleep Medicine
Volume 7, Issue 4 , Pages 368-373 , June 2006

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