Mechanisms of Upper Airway Obstruction

Tongue protrudor muscles will be stimulated

Outcome variables will be assess with and without mandibular advancement

Outcome variables will be measured with and without postural maneuvers

A digital camera with laser pointers will be used to capture a series of craniofacial photographs (frontal, profile and neck extended) and intra-oral photographs (junction of the hard and soft palate, airway, or base of tongue).

The patient will place a small bulb behind their lower incisors and will press using their tongue as hard as possible for two seconds. This exercise will be repeated four times, with 30 seconds of rest in between each attempt. The patient will then be instructed to press and hold their tongue against the bulb as hard as possible for 35 seconds. This exercise will be repeated three times, with 2 minutes of rest in between each attempt.

The patient will undergo an MRI scan of the head and neck.

The patient will undergo a polysomnography (PSG). The PSG study will include monitoring of EEG, submental EMG, EOG, SpO2, tidal airflow, thoraco-abdominal efforts, and body position. The patient will spend half of the night at baseline (i.e. no intervention), and the second half with lingual muscle stimulation activated.