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Dynamic spectrum policies combined with software defined radio are powerful means to improve the overall spectral efficiency allowing the development of new wireless services and technologies. Medium Access Control (MAC) protocols exploit sensing stimuli to build up a spectrum opportunity map (cognitive sensing). Available resources are scheduled (dynamic spectrum allocation), improving coexistence between users that belong to heterogeneous systems (dynamic spectrum sharing). Furthermore, MAC protocols may allow cognitive users to vacate selected channels when their quality becomes unacceptable (dynamic spectrum mobility). The contribution of this survey is threefold. First, we show the fundamental role of the MAC layer and identify its functionalities in a cognitive radio (CR) network. Second, a classification of cognitive MAC protocols is proposed. Third, advantages, drawbacks, and further design challenges of cognitive MAC protocols are discussed.