Mandible Behaviour during Sleep-disordered Breathing: a Surrogate for Oesophageal Pressure

INTRODUCTION: Just about everyone has noticed that snorers sleep with their mouths open; and, what's more, many sleep clinicians have observed that the jaw animates during sleep-disordered breathing events. Mandible position and activity during sleep has long been a subject of interest. In 1991 Hollowell and Suratt demonstrated that the jaws of patients with obstructive sleep apnea (OSA) are more open during sleep than the jaws of normal subjects [1]. They also showed that the jaw opens further during end inspiration in sleeping OSA patients. A later study concluded that mandibular opening increases progressively during apneic episodes and decreases at the termination of those episodes [2] and another that the jaw closes towards the clenched position during spontaneous arousals or arousals associated with termination of apneic events during sleep [3].