title: Mandible behaviour interpretation during wakefulness, sleep and sleep-disordered breathing.
abstract: The mandible movement (MM) signal provides information on mandible activity. It can be read visually to assess sleep-wake state and respiratory events. This study aimed to assess (1) the training of independent scorers to recognize the signal specificities; (2) intrascorer reproducibility and (3) interscorer variability. MM was collected in the mid-sagittal plane of the face of 40 patients. The typical MM was extracted and classified into seven distinct pattern classes: active wakefulness (AW), quiet wakefulness or quiet sleep (QW/S), sleep snoring (SS), sleep obstructive events (OAH), sleep mixed apnea (MA), respiratory related arousal (RERA) and sleep central events (CAH). Four scorers were trained; their diagnostic capacities were assessed on two reading sessions. The intra- and interscorer agreements were assessed using Cohen's κ. Intrascorer reproducibility for the two sessions ranged from 0.68 [95% confidence interval (CI): 0.59-0.77] to 0.88 (95% CI: 0.82-0.94), while the between-scorer agreement amounted to 0.68 (95% CI: 0.65-0.71) and 0.74 (95% CI: 0.72-0.77), respectively. The overall accuracy of the scorers was 75.2% (range: 72.4-80.7%). CAH MMs were the most difficult to discern (overall accuracy 65.6%). For the two sessions, the recognition rate of abnormal respiratory events (OAH, CAH, MA and RERA) was excellent: the interscorer mean agreement was 90.7% (Cohen's κ: 0.83; 95% CI: 0.79-0.88). The discrimination of OAH, CAH, MA characteristics was good, with an interscorer agreement of 80.8% (Cohen's κ: 0.65; 95% CI: 0.62-0.68). Visual analysis of isolated MMs can successfully diagnose sleep-wake state, normal and abnormal respiration and recognize the presence of respiratory effort.
authors: Service de pneumologie, Université catholique de Louvain, CHU Dinant Godinne, Yvoir, Belgium.
authors: Gisèle
authors: G
authors: Maury
authors: Montefiore Department for Microsystems and HELMO Gramme, University of Liège, Liège, Belgium.
authors: Frédéric
authors: F
authors: Senny
authors: Sleep/Wake Center of the University Hospital of Liège, University of Liège, Liège, Belgium.
authors: Laurent
authors: L
authors: Cambron
authors: Medical Informatics and Biostatistics, Laboratory, University of Liège, Liège, Belgium.
authors: Adelin
authors: A
authors: Albert
authors: Medical Informatics and Biostatistics, Laboratory, University of Liège, Liège, Belgium.
authors: Laurence
authors: L
authors: Seidel
authors: Sleep/Wake Center of the University Hospital of Liège, University of Liège, Liège, Belgium.
authors: Robert
authors: R
authors: Poirrier
mesh_terms: D000328:Adult; D000368:Aged; D001143:Arousal / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000502:physiology / Q000503:physiopathology*; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D015203:Reproducibility of Results; D012119:Respiration; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology*; D012913:Snoring; D014851:Wakefulness / Q000502:physiology*
chemical_list: D010100:Oxygen
keywords: breathing effort; mandible study; sleep study; visual analysis