The Relationship between Sleep Bruxism and Obstructive Sleep Apnea Based on Polysomnographic Findings

Martynowicz, Helena; Gać, Paweł; Brzecka, Anna; Poręba, Rafał; Wojakowska, Anna; Mazur, Grzegorz; Smardz, Joanna; Więckiewicz, Mieszko

doi:10.3390/jcm8101653

Cited by 70 publications

(86 citation statements)

References 30 publications

(37 reference statements)

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“…Fourthly, TMD and sleep bruxism may concomitantly present in OSA patients. The bruxism episode index (BEI) positively correlated with AHI in patients with mild-to moderate OSA, whereas patients with severe OSA had lower BEI than those with mild-to-moderate OSA [ 34 ]. Fifthly, SA patients, mostly OSA, may have craniofacial configurations and/or muscle dysfunction that predispose them to the development of TMD.…”

Section: Discussionmentioning

confidence: 99%

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

Lee

Kuo

et al. 2020

IJERPH

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An increased incidence of temporomandibular disorders (TMD) among patients with sleep apnea (SA) has been reported. However, the association between TMD and SA has not been demonstrated in a large-scale study. This population-based cohort study with the Taiwan National Health Insurance (NHI) Research Database aimed to understand the association between SA and TMD. We identified adult patients with suspected SA (identified with diagnostic codes) and excluded those diagnosed with TMD prior to SA. Patients with SA diagnosis after polysomnography were also identified as probable SA patients. The index dates were the dates of their initial SA diagnosis. Ten control subjects were matched, by age and sex, to each SA patient, and were assigned the same index dates as the SA patients. In total, 10,408 suspected SA patients (including 4105 probable SA patients) matched to 104,080 control subjects (including 41,050 subjects matched to the probable SA patients) in this study. The TMD incidence rate was significantly higher in the SA patients than in the control subjects (2.8 vs. 1.0 per thousand-patient-year in probable SA patients vs. the corresponding control subjects, with an adjusted incidence rate ratio [95% confidence interval] = 2.5 [2.3–2.7], p < 0.0001). SA patients significantly showed a higher cumulative incidence of TMD than the corresponding control subjects (p < 0.0001). Multivariable Cox regression analysis revealed SA as an independent risk factor for the development of TMD (adjusted hazard ratio = 2.5 [1.7–3.7], p < 0.0001). In summary, this study confirmed an increased TMD incidence in the SA patients. While treating TMD patients, dentists should pay careful attention to the potential underlying SA.

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Section: Discussionmentioning

confidence: 99%

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

Lee

Kuo

et al. 2020

IJERPH

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“…The third group or external factors are constituted by caffeine consumption, smoking, alcohol intake, and drug use. 12 Furthermore, the multifactorial origin of bruxism involves medical conditions and disorders such as obstructive sleep apnea (OSA), 13,14 diabetes, 14 increased body mass index (BMI), hypertension, 15,16 thyroid diseases, sleepiness, and snoring. 17 The contraction of cardiovascular diseases (CVDs) increases with age among patients with an established CVD and those at an increased risk of developing a CVD.…”

Section: Introductionmentioning

confidence: 99%

<p>Determination of Inflammatory Markers, Hormonal Disturbances, and Sleepiness Associated with Sleep Bruxism Among Adults</p>

Michałek-Zrąbkowska

Więckiewicz

Smardz

et al. 2020

NSS

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Purpose Sleep bruxism (SB) is characterized by repetitive phasic, tonic, or mixed masticatory muscle activity during sleep with multifactorial etiology. Previous studies have shown that the complex origin of SB can be related to the psychological features of the affected individual, consumption of caffeine and alcohol, smoking, obstructive sleep apnea, diabetes, increased body mass index, hypertension, thyroid diseases, and probable genetic vulnerability. This study aimed to investigate the inflammatory markers, hormonal disturbances, and sleepiness associated with SB, which have a potential effect on the total cardiovascular (CV) risk among relatively young and healthy patients. Patients and Methods A total of 74 individuals with probable SB were subjected to single-night polysomnography, followed by blood panel and 24-h urinary excretion tests. The level of daytime sleepiness was assessed in the participants using the Epworth Sleepiness Scale. Results SB was found in 78.4% of participants. The bruxism episode index (BEI) positively correlated with the concentrations of 17-hydroxycorticosteroids, C-reactive protein, and fibrinogen in the collected urine samples. A positive correlation was also found between phasic BEI and glucose concentration 2 h after the consumption of glucose solution. Sleep bruxers showed significantly increased sleepiness compared to nonbruxers ( p = 0.02). The scores on sleepiness were positively correlated with mixed BEI, minimal oxygen saturation, and mean heart rate. Conclusion The results of this study revealed that participants with SB had metabolic and hormonal disturbances, probably due to stress and sympathetic activity. Moreover, it was found that young sleep bruxers potentially have a high CV risk due to the increased level of inflammatory and stress markers.

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“…The disorder is defined as a repetitive jaw muscle activity characterized by clenching or grinding of teeth and/or by bracing or thrusting of the mandible [2]. Previous investigations found that the prevalence of sleep bruxism (SB) was about 50% in adults [3] whilst the prevalence of SB in children ranged from 3.5% to 40.6% [4]. Although signs and symptoms of bruxism vary, it is always supposed to be an etiological factor in causing damage to supporting structures of teeth, abnormal tooth wear, failure of dental restorations, and temporomandibular and musculoskeletal disorders [5].…”

Section: Introductionmentioning

confidence: 99%

Intelligent Occlusion Stabilization Splint with Stress-Sensor System for Bruxism Diagnosis and Treatment

Gao

Liu

Gao

et al. 2019

Sensors

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Bruxism is a masticatory muscle activity characterized by high prevalence, widespread complications, and serious consequences but without specific guidelines for its diagnosis and treatment. Although occlusal force-based biofeedback therapy is proven to be safe, effective, and with few side effects in improving bruxism, its mechanism and key technologies remain unclear. The purpose of this study was to research a real-time, quantitative, intelligent, and precise force-based biofeedback detection device based on artificial intelligence (AI) algorithms for the diagnosis and treatment of bruxism. Stress sensors were integrated and embedded into a resin-based occlusion stabilization splint by using a layering technique (sandwich method). The sensor system mainly consisted of a pressure signal acquisition module, a main control module, and a server terminal. A machine learning algorithm was leveraged for occlusal force data processing and parameter configuration. This study implemented a sensor prototype system from scratch to fully evaluate each component of the intelligent splint. Experiment results showed reasonable parameter metrics for the sensors system and demonstrated the feasibility of the proposed scheme for bruxism treatment. The intelligent occlusion stabilization splint with a stress sensor system is a promising approach to bruxism diagnosis and treatment.Sensors 2020, 20, 89 2 of 15 discussion summary, the existing assessment of bruxism could also be classified into three main aspects: (1) noninstrumental approaches, (2) instrumental approaches, and (3) cut-off points grading [6]. Self-report and clinical examination are considered as noninstrumental approaches, which are also the primary choices in the clinical assessment of bruxism. However, their reliability and validity need further improvement [6]. EMG may provide good evidence of both sleep and awake bruxism, but there is also a risk of overestimating the number of true SB events [7]. PSG could be regarded as a reference standard for SB assessment; however, it is expensive and time-consuming [2]. To date, the reliability and validity of all the common techniques remain debatable, and consensus has yet to be established regarding the best method to diagnose bruxism. Therefore, exploring some new methods of bruxism diagnosis and management is a necessary and meaningful research topic.The use of biofeedback technologies (electrical, auditory, vibratory stimulus, etc.) as behavioral techniques of bruxism diagnosis and treatment has been considered a promising approach in both clinical and scientific fields in recent years [8]. Various biofeedback modalities have been reported in previous papers, and most of these are based on EMG recordings, except two studies that described force-based devices [8,9]. An intra-splint force detector (ISFD) for SB force detection was described in 2003 [10]. A detailed description of this SB inhibition system has been presented in a recently published paper [11]. This inhibition system consisted of ISFD, vibration, and co...

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The Relationship between Sleep Bruxism and Obstructive Sleep Apnea Based on Polysomnographic Findings

Cited by 70 publications

References 30 publications

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

<p>Determination of Inflammatory Markers, Hormonal Disturbances, and Sleepiness Associated with Sleep Bruxism Among Adults</p>

Intelligent Occlusion Stabilization Splint with Stress-Sensor System for Bruxism Diagnosis and Treatment

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