Marghalani Thamer Y, Salamah Ruwaa M, Alangari Haitham M
Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
Ministry of Health, Madinah 42351, Saudi Arabia.
Life (Basel). 2024 Jul 29;14(8):952. doi: 10.3390/life14080952.
Obstructive sleep apnea (OSA) is a prevalent source of sleep-disordered breathing. OSA is most commonly associated with dysfunctions in the genioglossus (GG) muscle. In this study, we present the first version of a medical device that produces an electromyogram (EMG) of the GG. The prototype is composed of a (custom-made) 3D-printed mouthpiece. Impressions were taken for the lower arch and scanned with a lab scanner to be converted into digital impressions. ExoCad software was used to design the appliance. Fusion 360 software was then used to modify the design and create tubes to house the electrodes in a bilateral configuration to secure excellent and continuous contact with the GG muscle. Silver-silver chloride electrodes were incorporated within the appliance through the created tubes to produce a muscle EMG. In this preliminary prototype, an EMG amplifier was placed outside the mouth, and isolated electric wires were connected to the amplifier input. To test the design, we ran experiments to acquire EMG signals from a group of OSA patients and a control group in wakefulness. The GG EMGs were acquired from the participants for 60 s in a resting state whereby they rested their tongues without performing any movement. Then, the subjects pushed their tongues against the fontal teeth with steady force while keeping the mouth closed (active state). Several features were extracted from the acquired EMGs, and statistical tests were applied to evaluate the significant differences in these features between the two groups. The results showed that the mean power and standard deviation were higher in the control group than in the OSA group ( < 0.01). Regarding the wavelength during the active state, the control group had a significantly longer wavelength than the OSA group ( < 0.01). Meanwhile, the mean frequency was higher in the OSA group ( < 0.01) at rest. These findings support research that showed that impairment in GG activity continues in the daytime and does not only occur during sleep. Future research should focus on developing the device to be more user-friendly and easily used at home during wakefulness and sleep.
阻塞性睡眠呼吸暂停（OSA）是睡眠呼吸紊乱的常见原因。OSA最常与颏舌肌（GG）功能障碍相关。在本研究中，我们展示了首款能够产生GG肌电图（EMG）的医疗设备。该原型由一个（定制的）3D打印咬嘴组成。取下颌牙弓印模并用实验室扫描仪进行扫描，以转换为数字印模。使用ExoCad软件设计矫治器。然后使用Fusion 360软件修改设计并创建管道，将电极以双侧配置安置在管道内，以确保与GG肌保持良好且持续的接触。通过创建的管道将银 - 氯化银电极并入矫治器中，以产生肌肉EMG。在这个初步原型中，EMG放大器放置在口腔外，隔离电线连接到放大器输入端。为了测试该设计，我们进行了实验，以在清醒状态下从一组OSA患者和一个对照组获取EMG信号。在静息状态下，让参与者保持舌头静止不动，不进行任何运动，持续60秒，从他们身上采集GG肌电图。然后，受试者在闭嘴的同时用稳定的力量将舌头抵住前牙（主动状态）。从采集到的肌电图中提取了几个特征，并应用统计测试来评估两组之间这些特征的显著差异。结果显示，对照组的平均功率和标准差高于OSA组（<0.01）。关于主动状态下的波长，对照组的波长明显长于OSA组（<0.01）。同时，在静息状态下，OSA组的平均频率更高（<0.01）。这些发现支持了相关研究，即表明GG活动的损害在白天持续存在，而不仅仅发生在睡眠期间。未来的研究应专注于开发更便于用户使用且能在清醒和睡眠期间在家中轻松使用的设备。
