Due to the high prevalence of obstructive sleep apnea , numerous studies are being conducted to expand diagnostic methods. Research groups worldwide, composed of highly competent specialists, are constantly searching for reliable and accessible diagnostic alternatives to reach a larger population.
One of the most notable studies was conducted in São Paulo in 2010 under the leadership of Dr. Sergio Tufik, one of the world’s most renowned sleep medicine researchers. The study, involving 1,000 participants who underwent polysomnography, found that one in three patients (33%) had OSA. Years later, a similar study in Switzerland reported an even higher prevalence.
As discussed in previous publications, polysomnography is a complex and resource-intensive test with limited availability. Even in large cities, the number of diagnostic devices is insufficient to meet the demand for sleep apnea testing. The service is often unavailable in smaller cities, forcing patients to travel long distances for testing. Additionally, polysomnography is costly, as each analysis requires detailed technical and medical evaluation, producing reports of up to 700 pages per patient.
Another limitation is that the test is conducted over a single night, which can introduce bias. Research has shown that night-to-night variability can alter OSA severity by up to 30%, either increasing or decreasing its classification.
Today’s article highlights groundbreaking research on mandibular movements during sleep.
The jaw plays a fundamental role in preventing pharyngeal obstruction. During normal sleep (without bruxism), it performs low-amplitude physiological movements. Under ideal conditions, nasal breathing predominates, and the mouth remains closed most of the time.
Airway stability relies on a delicate balance, in which the jaw acts as a lever, enhancing pharyngeal muscle tone. This process activates trigeminal motoneurons, which help counteract negative inspiratory pressure. Additionally, when the jaw moves forward, it carries the tongue with it, reducing the risk of airway collapse.
During polysomnography, researchers used a device placed on the chin region to analyze signals produced by mandibular movements in different situations, including normal sleep, snoring, reduced respiratory flow and partial or total airway obstruction.
According to preliminary results, mandibular movement analysis offers several key advantages, such as the detection of the presence of OSA, a precise differentiation between obstructive sleep apnea and central sleep apnea (including hypopneas) and the identification of sleep stages.
This innovative approach also provides several benefits over traditional methods: multi-night evaluation, reducing variability concerns; lower costs, increasing accessibility; and flexibility, allowing use in diverse settings.
Despite these promising findings, the authors emphasize that further large-scale studies are necessary to validate the results and refine the methodology.
Scientific research and technological advancements continue to drive progress in sleep medicine.
Combining clinical expertise with innovations brings us closer to more effective diagnostic solutions.
As Belchior once said, “Good things always come.”
By Dr. Walter Silva Júnior
Sleep dentist certified by the American Board of Dental Sleep Medicine (ABDSM).
Ph.D. in Sleep Medicine at the Hospital for Rehabilitation of Craniofacial Anomalies/University of São Paulo – Bauru, São Paulo.
Website: http://www.institutowaltersilva.com.br/
Instagram: @walter_silva_odontologiadosono
REFERENCE: Insights on mandibular jaw movements during polysomnography in obstructive sleep apnea.
Malhotra A, Martinot JB, Pepin JL.
J Clin Sleep Med. 2024;20(1):151–163.
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Diagnosing obstructive sleep apnea is both simple and essential.
The Biologix Sleep Test® is a remote polysomnography that monitors oxygen saturation, heart rate, actigraphy, and snoring using a smartphone microphone.
Designed for at-home use, this test offers a simple yet effective method for healthcare practitioners to diagnose and monitor sleep apnea. At bedtime, the patient only needs to place the sensor on their finger and start the test in the Biologix app. Upon waking up the next morning, after finishing the test, the result will be available at the exam portal in a matter of seconds.
