基于阻塞性睡眠呼吸暂停患者不同颌面部肌肉肌电图轨迹的睡眠磨牙症评分准确性
Accuracy of sleep bruxism scoring based on electromyography traces of different jaw muscles in individuals with obstructive sleep apnea.
作者信息
Li Deshui, Aarab Ghizlane, Lobbezoo Frank, Arcache Patrick, Lavigne Gilles J, Huynh Nelly
机构信息
Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Faculté de Médicine Dentaire, Université de Montréal, Montreal, Canada.
出版信息
J Clin Sleep Med. 2022 Jun 1;18(6):1609-1615. doi: 10.5664/jcsm.9940.
STUDY OBJECTIVES
Sleep bruxism is characterized by rhythmic masticatory muscle activity (RMMA). This study aimed to determine the number and type of jaw muscles needed for a valid RMMA scoring in individuals with obstructive sleep apnea.
METHODS
Ten individuals with obstructive sleep apnea (4 males; age, 50.1 ± 8.1 years) were included in this study. RMMA was scored using 1 or more of the following jaw muscles' electromyography (EMG) traces of polysomnography recordings: bilateral masseter and temporalis (4MT; the reference standard), unilateral masseter (1M), bilateral masseter (2M), unilateral temporalis (1T), bilateral temporalis (2T), unilateral chin EMG (1C), and bilateral chin EMG (2C).
RESULTS
1M, 2M, 1T, and 2T showed excellent agreement with 4MT (intraclass correlation coefficient = 0.751, 0.976, 0.815, and 0.950, respectively), while 1C and 2C presented fair agreement (intraclass correlation coefficient = 0.662 and 0.657). In addition, 2M and 2T displayed good sensitivity (87.8% and 72.0%) and positive predictive value (83.1% and 76.0%). In contrast, 1M and 1T had good sensitivity (88.4% and 87.8%) but fair positive predictive value (60.1% and 53.2%). 1C and 2C showed poor sensitivity (41.1% and 40.3%) and fair positive predictive value (62.9% and 60.6%).
CONCLUSIONS
Polysomnography with bilateral masseter or temporalis muscle EMG traces is regarded valid in RMMA scoring in individuals with obstructive sleep apnea. In contrast, unilateral masseter or temporalis muscle EMG showed only fair accuracy, and chin EMG had poor accuracy. Consequently, these montages cannot be recommended for RMMA scoring in the presence of obstructive sleep apnea.
CLINICAL TRIAL REGISTRATION
Registry: ClinicalTrials.gov; Name: The Effects of Oral Appliance Therapy on Masseter Muscle Activity in Obstructive Sleep Apnea; URL: https://clinicaltrials.gov/ct2/show/NCT02011425; Identifier: NCT02011425.
CITATION
Li D, Aarab G, Lobbezoo F, Arcache P, Lavigne GJ, Huynh N. Accuracy of sleep bruxism scoring based on electromyography traces of different jaw muscles in individuals with obstructive sleep apnea. . 2022;18(6):1609-1615.
研究目的
睡眠磨牙症的特征是有节律的咀嚼肌活动（RMMA）。本研究旨在确定在阻塞性睡眠呼吸暂停患者中进行有效RMMA评分所需的颌骨肌肉数量和类型。
方法
本研究纳入了10名阻塞性睡眠呼吸暂停患者（4名男性；年龄，50.1±8.1岁）。使用多导睡眠图记录中的以下颌骨肌肉肌电图（EMG）轨迹中的1种或多种对RMMA进行评分：双侧咬肌和颞肌（4MT；参考标准）、单侧咬肌（1M）、双侧咬肌（2M）、单侧颞肌（1T）、双侧颞肌（2T）、单侧颏肌肌电图（1C）和双侧颏肌肌电图（2C）。
结果
1M、2M、1T和2T与4MT显示出极好的一致性（组内相关系数分别为0.751、0.976、0.815和0.950），而1C和2C的一致性一般（组内相关系数为0.662和0.657）。此外，2M和2T表现出良好的敏感性（87.8%和72.0%）和阳性预测值（83.1%和76.0%）。相比之下，1M和1T具有良好的敏感性（88.4%和87.8%），但阳性预测值一般（60.1%和53.2%）。1C和2C显示出较差的敏感性（41.1%和40.3%）和一般的阳性预测值（62.9%和60.6%）。
结论
在阻塞性睡眠呼吸暂停患者的RMMA评分中，采用双侧咬肌或颞肌肌电图轨迹的多导睡眠图被认为是有效的。相比之下，单侧咬肌或颞肌肌电图的准确性一般，而颏肌肌电图的准确性较差。因此，在存在阻塞性睡眠呼吸暂停的情况下，不建议使用这些导联组合进行RMMA评分。
临床试验注册
注册机构：ClinicalTrials.gov；名称：口腔矫治器治疗对阻塞性睡眠呼吸暂停患者咬肌活动的影响；网址：https://clinicaltrials.gov/ct2/show/NCT02011425；标识符：NCT02011425。
引用
Li D, Aarab G, Lobbezoo F, Arcache P, Lavigne GJ, Huynh N. 基于阻塞性睡眠呼吸暂停患者不同颌骨肌肉肌电图轨迹的睡眠磨牙症评分准确性。. 2022;18(6):1609 - 1615。
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