Temporal association between sleep apnea–hypopnea and sleep bruxism events

Abstract

SUMMARYThere is some evidence suggesting that obstructive sleep apneahypopnea syndrome is concomitant with sleep bruxism. The aim of this study was to investigate the temporal association between sleep apneahypopnea events and sleep bruxism events. In an open observational study, data were gathered from 10 male subjects with confirmed obstructive sleep apnea-hypopnea syndrome and concomitant sleep bruxism. Polysomnography and audio-video recordings were performed for 1 night in a sleep laboratory. Breathing, brain, heart and masticatory muscle activity signals were analysed to quantify sleep and sleep stage duration, and number and temporal distribution of apnea-hypopnea events and sleep bruxism events. Apnea-hypopnea events were collected within a 5-min time window before and after sleep bruxism events, with the sleep bruxism events as the pivotal reference point. Two temporal patterns were analysed: (i) the interval between apneahypopnea events termination and sleep bruxism events onset, called T1; and (ii) the interval between sleep bruxism events termination and apnea-hypopnea events onset, called T2. Of the intervals between sleep bruxism events and the nearest apnea-hypopnea event, 80.5% were scored within 5 min. Most intervals were distributed within a period of <30 s, with peak at 0-10 s. The T1 interval had a mean length of 33.4 s and was significantly shorter than the T2 interval (64.0 s; P < 0.05). Significantly more sleep bruxism events were scored in association with the T1 than the T2 pattern (P < 0.05). Thus, in patients with concomitant obstructive sleep apnea-hypopnea syndrome and sleep bruxism, most sleep bruxism events occurred after sleep apnea-hypopnea events, suggesting that sleep bruxism events occurring close to sleep apneahypopnea events is a secondary form of sleep bruxism.

Weak association between sleep bruxism and obstructive sleep apnea. A sleep laboratory study

“…In this study, because we know that a weak temporal sequence of OSAH triggers RMMA [5], we hypothesized that the number of AH events will correlate with the number of SB events, further supporting a weak association between OSAH and SB. The analysis was performed in subjects who reported concomitant SB-tooth grinding and sleep apnea-hypopnea complaints, in other words, patients with suspected concomitant OSAS and SB.…”

“…Some patients report concomitant complaints related to sleep bruxism (SB) and obstructive sleep apnea-hypopnea (OSAH) [1][2][3][4][5][6]. However, the strength and specificity of this association during sleep remain debated in the literature.…”

“…For example, the use of different methods to assess SB presence (e.g., questionnaire alone vs. advanced sleep recording and scoring methods) is probably a major cause of discrepancy [1][2][3][4][5][6][7][8]. A recent sleep laboratory study in a large general population sample with wide age range failed to show any strong correlations between sleep breathing variables and SB [11].…”

“…In a previous paper, we reported from a nonconsecutive case series our attempt to determine causality between SB and OSAH using a temporal analysis of co-occurrences of jaw muscle activity and apnea-hypopnea [5]. In summary, our results showed that almost half the SB events (i.e., rhythmic masticatory muscle activity -RMMA) occurred after sleep apnea-hypopnea events, suggesting a weak association, and that whereas some SB-related RMMA were concomitant to OSAH, others were probably not related to apnea-hypopnea.…”

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

“…Saito et al 50 (2014) avaliaram com polissonografia a presença de uma associação temporal entre os episódios de BS e de AOS em pacientes com diagnóstico positivo de ambas patologias. Os autores observaram que os episódios de RMMA ocorreram mais frequentemente após eventos respiratórios, apesar de a situação contrária também se mostrar presente.…”