Jaw Movement During Sleep
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Date
2008-09-04T16:33:53Z
Authors
Le Huquet, Ariel
Keyword
Mandibular movement , Jaw Movement , Obstructive Sleep Apnea , Sleep , Upper Airway , Physiology
Abstract
Objective: We aim to improve our understanding of sleep physiology by describing the
changes in mandibular position during sleep in normal subjects. Methods: We developed
a novel method for mapping mandibular position simultaneously in three dimensions
(anteroposterior, vertical and lateral) using magneto-resistive sensors strategically placed
around 3 different moving joints on an external apparatus attached to the head and
mandible. Spherical coordinates derived from these sensors provided information of jaw
position in each of the three measurement planes. We assessed changes in jaw position in
twelve healthy subjects (6 male, 6 female) aged (mean ± SD) 23 ± 7 years, Body Mass
Index 22.5 ± 3.4 kg/m2, and with nasal resistance 3.24 ± 0.67 cmH2O/L/s by recording
mandibular position simultaneously with overnight sleep polysomnography. Results: Jaw
position was significantly influenced by sleep stage (p<0.001). The transition from wake
to light sleep (stage one) was accompanied by significant jaw closure and jaw protrusion
(p<0.05). As non-rapid-eye-movement (NREM) sleep deepened from stages 1 through
slow wave sleep (SWS), vertical jaw opening (p<0.05) and posterior jaw movement
progressively increased (p<0.05). REM sleep was associated with the greatest degree of
jaw opening of all sleep stages (p<0.05). Lateral jaw position was not significantly
different between sleep stages. Conclusion: This study describes, for the first time, an
accurate method of measuring changes in mandibular position during sleep in all three
dimensions. The observed changes during sleep in healthy subjects suggest a
simultaneous modulation of upper airway muscular tone, which may be important in the
understanding of upper airway occlusion in Obstructive Sleep Apnea.