Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
School of Electrical, Electronics, and Computer Engineering, Mapúa University, Manila, Philippines.
J Sleep Res. 2020 Aug;29(4):e13032. doi: 10.1111/jsr.13032. Epub 2020 Apr 17.
Obstructive sleep apnea is a chronic breathing disorder where the recursive collapse of the upper airway causes cessation of airflow during sleep. Quantitative assessments of dynamic tongue motion may provide a better understanding of the mechanism of obstructive sleep apnea. Tongue area changes, in submental ultrasound images recorded during wakefulness from normal breathing by the Müller manoeuvre, were tracked using the modified optical flow-based method. The results demonstrated that patients with obstructive sleep apnea had a larger mid-sagittal tongue area compared to the control group (during normal breathing, p = .004, during the Müller manoeuvre p = .005, and differences between normal breathing and the Müller manoeuvre, p = .01). Tongue area measurements were significantly different in patients with varying severity of OSA during normal breathing and during the Müller manoeuvre, and had differences between normal breathing and the Müller manoeuvre (p = .005, p = .008 and p = .03, respectively). Patients with moderate or severe obstructive sleep apnea exhibited minimal movement of the tongue. In contrast, normal controls and patients with mild obstructive sleep apnea demonstrated bidirectional tongue motions during a transition from normal breathing to the Müller manoeuvre in wakefulness. Identifying different patterns of deformation and displacement of the tongue may have potential in evaluating the presence and the pathogenesis of OSA.
阻塞性睡眠呼吸暂停是一种慢性呼吸紊乱,其特征是上气道反复塌陷,导致睡眠期间气流停止。定量评估舌动态运动可能有助于更好地理解阻塞性睡眠呼吸暂停的发病机制。采用改进的光流法追踪颏下超声记录的清醒状态下正常呼吸的 Müller 动作期间舌面积的变化。结果表明,与对照组相比,阻塞性睡眠呼吸暂停患者的中矢状舌面积更大(正常呼吸时,p=0.004;Müller 动作时,p=0.005;正常呼吸和 Müller 动作之间的差异,p=0.01)。在正常呼吸和 Müller 动作时,不同严重程度的 OSA 患者的舌面积测量值差异显著,且正常呼吸和 Müller 动作之间也有差异(p=0.005、p=0.008 和 p=0.03)。中重度阻塞性睡眠呼吸暂停患者的舌运动最小。相比之下,正常对照组和轻度阻塞性睡眠呼吸暂停患者在清醒状态下从正常呼吸过渡到 Müller 动作时表现出双向舌运动。识别舌的不同变形和位移模式可能有助于评估 OSA 的存在和发病机制。