Home-Based Monitoring of Eating in Adolescents: A Pilot Study.

OBJECTIVES: To investigate eating episodes in a group of adolescents in their home-setting using wearable electromyography (EMG) and camera, and to evaluate the agreement between the two devices. APPROACH: Fifteen adolescents (15.5 ± 1.3 years) had a smartphone-assisted wearable-EMG device attached to the jaw to assess chewing features over one evening. EMG outcomes included chewing pace, time, episode count, and mean power. An automated wearable-camera worn on the chest facing outwards recorded four images/minute. The agreement between the camera and the EMG device in detecting eating episodes was evaluated by calculating specificity, sensitivity, and accuracy. MAIN RESULTS: The features of eating episodes identified by EMG throughout the entire recording time were (mean (SD)); chewing pace 1.64 (0.20) Hz, time 10.5 (10.4) minutes, episodes count 56.8 (39.0), and power 32.1% (4.3). The EMG device identified 5.1 (1.8) eating episodes lasting 27:51 (16:14) minutes whereas the cameras indicated 2.4 (2.1) episodes totaling 14:49 (11:18) minutes, showing that the EMG-identified chewing episodes were not all detected by the camera. However, overall accuracy of eating episodes identified ranged from 0.8 to 0.92. SIGNIFICANCE: The combination of wearable EMG and camera is a promising tool to investigate eating behaviors in research and clinical-settings.

Mandibular advancement appliances for sleep-disordered breathing in children: A randomized crossover clinical trial.

OBJECTIVE: To test the short-term effectiveness of a mandibular advancement splint (MAS) for the management of sleep-disordered breathing (SDB) in children. METHODS: Eighteen SDB children were enrolled in a crossover randomized clinical trial and assigned to a treatment sequence starting either with an Active or a Sham MAS. Each appliance was worn for three weeks and treatment periods were separated by a two-week washout. Home-based polysomnographic data were collected before and after each treatment period. In addition, blood samples were collected at the end of each treatment period to assess serum levels of insulin-like growth factor-1 (IGF-1). The apnea-hypopnea index (AHI) and snoring time represented the main outcome variables. Secondary outcomes included IGF-1 levels, and questionnaire scores for quality of life and behavior. RESULTS: Compared to the Sham MAS, the wearing of the Active MAS resulted in a significant reduction in overall AHI (-37%; 95% CI = 15-53%; p = 0.002) and supine AHI (-4.1 events per hour; 95% CI = 1.8-6.4; p < 0.001). Mean snoring time per night was shorter with the Active MAS than with the Sham MAS (-46.3 min; 95% CI = 14.5-78.1; p = 0.004). Wearing of the Active MAS improved the ratings of quality of life and behavior (P ≤ 0.028), but there was no evidence that it influenced IGF-1 levels (P = 0.172). CONCLUSION: Wearing an Active MAS overnight, over a short period can be beneficial for SDB children, resulting in a clinically relevant reduction of supine AHI.