Relationships between respiratory and oromotor events differ between motor phenotypes in patients with obstructive sleep apnea

Abstract

PurposeThe present study investigated the relationship between sleep bruxism (SB) and obstructive sleep apnea (OSA) in relation to the sleep architecture.MethodsWe conducted a cross-sectional study. Polysomnographic recordings were performed on 36 patients. Sleep, respiratory, and oromotor variables, such as rhythmic masticatory muscle activity (RMMA) and non-specific masticatory muscle activity (NSMA), were compared between OSA patients with or without SB. A correlation analysis of the frequency of respiratory and oromotor events in NREM and REM sleep was performed. The frequency of oromotor events following respiratory events was also assessed.ResultsThe proportion of REM sleep was higher in OSA patients with SB than in those without SB (p = 0.02). The apnea-hypopnea index (AHI) did not significantly differ between the two groups; however, AHI was approximately 8-fold lower during REM sleep in OSA patients with SB (p = 0.01) and the arousal threshold was also lower (p = 0.04). Although the RMMA index was higher in OSA patients with than in those without SB (p < 0.01), the NSMA index did not significantly differ. The percentage of RMMA following respiratory events was significantly higher in OSA patients with than in those without SB, whereas that of NSMA did not significantly differ. The frequency of oromotor events throughout the whole night positively correlated with AHI. However, regardless of the sleep state, AHI did not correlate with the RMMA index, but positively correlated with the NSMA index.ConclusionIn consideration of the limitations of the present study, the results obtained indicate that OSA patients with SB have a unique phenotype of OSA and also emphasize the distinct relationship of respiratory events with RMMA and NSMA.

A case–control study on the effect of rhythmic masticatory muscle activity (RMMA) clusters on sleep fragmentation and severity of orofacial muscle pain in sleep bruxism

“…Previous studies have proposed different pathogenesis for tonic events compared with phasic and mixed events, as well as a relationship between the TERT gene polymorphism and phasic events but not tonic events (Macek et al, 2022). The positive correlation between hypoxia and phasic events, but not tonic events, supports the hypothesis that phasic and tonic types of bruxism exhibit distinct features and roles (Michalek-Zrabkowska, Wieckiewicz, Haraki et al, 2023;Okura et al, 2023). Recently, Toyota et al (2022) demonstrated a significantly higher frequency of RMMA and percentage of arousals with RMMA in subjects with sleep bruxism compared with controls, with no significant differences observed for nonrhythmic promotor events.…”

Diagnostic Accuracy of a Portable Electromyography and Electrocardiography Device to Measure Sleep Bruxism in a Sleep Apnea Population: A Comparative Study

“…Another study, conducted by Saito, found a positive and significant correlation between OMA and AHI [24]. As Kato pointed out in 1999, the OMA activity may introduce a bias if it is not excluded from the neurophysiological analyses [62].…”

Relação entre bruxismo do sono e apneia obstrutiva do sono: Uma revisão de literatura

“…Por fim, Okura, et al, 2023 sugerem que pacientes que apresentam tanto AOS quanto BS possuem um fenótipo fisiológico único de AOS. Esses achados apoiam descobertas anteriores que indicam que os eventos respiratórios durante o sono não são um gatilho direto para RMMA.…”

“…A maioria dos eventos de apneia central ocorreu após o episódio de BS; pacientes com apneia grave apresentam tendência a ter índices de bruxismo mais elevados quando comparados a pacientes com apneia leve e moderada. Okura, et al, (2023) Relationships between respiratory and oromotor events differ between motor phenotypes in patients with obstructive sleep apnea.…”