Neurophysiological basis of respiratory discomfort improvement by mandibular advancement in awake OSA patients - Sorbonne Université
Article Dans Une Revue Physiological Reports Année : 2024

Neurophysiological basis of respiratory discomfort improvement by mandibular advancement in awake OSA patients

Résumé

Patients with obstructive sleep apneas (OSA) do not complain from dyspnea during resting breathing. Placement of a mandibular advancement device (MAD) can lead to a sense of improved respiratory comfort ("pseudo-relief") ascribed to a habituation phenomenon. To substantiate this conjecture, we hypothesized that, in non-dyspneic awake OSA patients, respiratory-related electroencephalographic figures, abnormally present during awake resting breathing, would disappear or change in parallel with MAD-associated pseudo-relief. In 20 patients, we compared natural breathing and breathing with MAD on: breathing discomfort (transitional visual analog scale, VAS-2); upper airway mechanics, assessed in terms of pressure peak/time to peak (TTP) ratio respiratory-related electroencephalography (EEG) signatures, including slow event-related preinspiratory potentials; and a between-state discrimination based on continuous connectivity evaluation. MAD improved breathing and upper airway mechanics. The 8 patients in whom the EEG between-state discrimination was considered effective exhibited higher Peak/TTP improvement and transitional VAS ratings while wearing MAD than the 12 patients where it was not. These results support the notion of habituation to abnormal respiratory-related afferents in OSA patients and fuel the causative nature of the relationship between dyspnea, respiratory-related motor cortical activity and impaired upper airway mechanics in this setting.

Domaines

Neurosciences
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Dates et versions

hal-04471365 , version 1 (21-02-2024)

Identifiants

Citer

Rémi Valentin, Marie-Cécile Niérat, Nicolas Wattiez, Olivier Jacq, Maxens Decavèle, et al.. Neurophysiological basis of respiratory discomfort improvement by mandibular advancement in awake OSA patients. Physiological Reports, 2024, ⟨10.14814/phy2.15951⟩. ⟨hal-04471365⟩
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