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Martynowicz H, Lavigne G, Kato T, Poreba R, Michalek-Zrabkowska M, Macek P, Gac P, Wojakowska A, Surowiak P, Mazur G, Wieckiewicz M. 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. J Sleep Res 2024; 33:e14072. [PMID: 37859534 DOI: 10.1111/jsr.14072] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/14/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023]
Abstract
Rhythmic masticatory muscle activity (RMMA) is a periodic muscle activity that characterises sleep bruxism (SB) events. These can occur as a single event, in pairs, or in clusters. Since RMMA episodes often occur in clusters and the relevance of this occurrence is unknown, we conducted a study to investigate the effect of RMMA clusters on sleep fragmentation and the severity of orofacial muscle pain. This study involved a secondary analysis using data from 184 adult subjects with orofacial muscle pain who underwent definitive polysomnography (PSG) for sleep bruxism diagnosis. Self-reported orofacial muscle pain (OFMP) was assessed using the numeric rating scale, and additional evaluation of side-to-side equivalence (symmetry) was described using a binary system. Among the 184 participants, 60.8% (n = 112) did not exhibit clusters and among the 72 participants with clusters, 36.1% (n = 26) and 63.9% (n = 46) were in the high and low RMMA frequency groups, respectively. The high SB group had significantly three times more phasic RMMA events than the noncluster group. A total of 89.67% (n = 165) of subjects reported orofacial muscle pain. While there was no difference in the severity of OFMP among groups, a significant decrease in symmetry between the severity of temporal muscle pain on the left and right sides was noted in the cluster group compared with the noncluster group. Clustering of RMMA events is associated with sleep fragmentation. The asymmetry of temporal muscle pain is related to the presence of RMMA clusters in sleep bruxism.
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Affiliation(s)
- Helena Martynowicz
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Gilles Lavigne
- Faculty of Dental Medicine, Universite de Montreal, CIUSSS Nord Ile de Montreal and CHUM, Montreal, Canada
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Rafal Poreba
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Monika Michalek-Zrabkowska
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Macek
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Pawel Gac
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Wojakowska
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Pawel Surowiak
- Department of Histology and Embryology, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Grzegorz Mazur
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
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Ishimaru T, Yamaguchi T, Saito T, Hattori Y, Ono T, Arai Y, Hasegawa Y, Shiga H, Tamaki K, Tanaka J, Tsuga K, Abekura H, Miyawaki S, Maeda-Iino A, Mikami S, Gotouda A, Satoh K, Shimizu K, Kato Y, Namita T. Actual state of the diurnal masseteric electromyogram: Differences between awareness and non-awareness of awake bruxism. J Prosthodont Res 2024; 68:456-465. [PMID: 38220162 DOI: 10.2186/jpr.jpr_d_23_00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
PURPOSE This study aimed to elucidate the relationship between diurnal masseter muscle activity and awareness of diurnal awake bruxism (d-AB) by conducting a comparative analysis of electromyographic (EMG) data from individuals with and without awareness of diurnal awake bruxism (d-AB), utilizing EMG data gathered from multiple subjects. METHODS Unilateral masseter electromyography (EMG) recordings were performed during the daytime using an ultraminiature wearable EMG device. A total of 119 participants (59 with awareness of diurnal tooth clenching [d-TC] and 60 without awareness of d-TC) were included. Waveforms longer than 0.25 s with the two amplitude conditions, exceeding twice the baseline and >5% of maximum voluntary clenching, were extracted. In addition, the number of bursts and episodes (groups of bursts), burst duration, and burst peak amplitude were calculated for each participant. RESULTS There were no significant differences in the EMG parameters between the groups with and without awareness of d-TC. Additionally, the frequency distribution of the number of EMG waveforms exhibited wide ranges and substantial overlap between the two groups. CONCLUSIONS The variability in the number of bursts and episodes, burst peak amplitude, and burst duration among subjects suggests the need for an objective classification of d-AB severity based on EMG values. The absence of significant differences and large overlap in frequency distributions between the groups with and without awareness of d-TC indicate difficulty in predicting muscle activity solely based on awareness of d-AB.
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Affiliation(s)
- Tomoya Ishimaru
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taishi Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Yoshiaki Arai
- Oral Implant & Temporomandibular Joint Clinic, Niigata University Medical & Dental Hospital, Niigata, Japan
| | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroshi Shiga
- Department of Partial and Complete Denture, The Nippon Dental University School of Life Dentistry, Tokyo, Japan
| | - Katsushi Tamaki
- Graduate School of Dentistry, Kanagawa Dental University Department of Oral Interdisciplinary Medicine (OIM) Division of Prosthodontic Dentistry for function of TMJ and Occlusion, Yokosuka, Japan
| | - Junko Tanaka
- Department of Fixed Prosthodontics and Occlusion Osaka Dental University, Osaka, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan
| | - Hitoshi Abekura
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shouichi Miyawaki
- Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Aya Maeda-Iino
- Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Saki Mikami
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Kaoru Satoh
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Koichi Shimizu
- School of Optoelectronic Engineering, Xidian University, Xi'an, China
| | - Yuji Kato
- Faculty of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Takeshi Namita
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Tokyo, Japan
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Maejima K, Takaba M, Abe Y, Ohara H, Aoki R, Matsuyama M, Okuhara S, Baba K. Effects of vibratory feedback stimuli through an oral appliance on sleep bruxism: A 14-week intervention trial. J Dent Sci 2024; 19:1714-1721. [PMID: 39035344 PMCID: PMC11259639 DOI: 10.1016/j.jds.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/11/2023] [Accepted: 11/12/2023] [Indexed: 07/23/2024] Open
Abstract
Background/purpose Various biofeedback stimulation techniques for managing sleep bruxism (SB) have recently emerged; however, the effect of the successive application of vibratory feedback stimulation has not been clarified. This study aimed to elucidate the effect of vibration feedback stimulation via an oral appliance (OA) on SB. Materials and methods This prospective, single-arm, open-label intervention study included 20 participants diagnosed with "definite" SB who wore a specially designed OA for 98 nights at home. A force-based SB detection system triggered a vibrator attached to the OA. Vibratory stimulation was withheld during the first 3-week adaptation period (weeks 1-3), applied during the 9-week stimulation period (weeks 4-12), and withheld again during the post-stimulation period (weeks 13-14). The number and duration of SB events per hour of sleep were calculated based on piezoelectric signals recorded with the OA-based vibration feedback device and compared between weeks 3 and 4, 8, 12, and 14 and between weeks 12 and 14 using the Friedman test (post-hoc test with Bonferroni correction). Results The duration of SB events significantly decreased after vibratory stimulation (weeks 3 versus 4, 8, and 12: P < 0.001, P = 0.026, and P = 0.033, respectively) and then significantly increased upon cessation of vibratory stimulation after the stimulation period (weeks 12 versus 14: P < 0.001). Conclusion Contingent vibratory stimulation through an OA-based vibration feedback device may suppress SB-related masticatory muscle activity continuously for 9 weeks and may be an effective alternative for managing SB.
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Affiliation(s)
- Kohei Maejima
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Masayuki Takaba
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Yuka Abe
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Hironobu Ohara
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Risa Aoki
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Megumi Matsuyama
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Shiori Okuhara
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Kazuyoshi Baba
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
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Thomas DC, Manfredini D, Patel J, George A, Chanamolu B, Pitchumani PK, Sangalli L. Sleep bruxism: The past, the present, and the future-evolution of a concept. J Am Dent Assoc 2024; 155:329-343. [PMID: 38363252 DOI: 10.1016/j.adaj.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND The concept of sleep bruxism (SB) has evolved exponentially over the past several decades. Many theories and hypotheses have been proposed as to the definition, pathophysiology, and management of SB, from the early 1960s through the present. The role of peripheral factors, such as dental occlusion, in the pathogenesis of SB has been discarded. TYPES OF STUDIES REVIEWED The authors searched several electronic databases (ie, PubMed, Google Scholar, Web of Science, Embase, and Ovid MEDLINE) for studies on bruxism. The search was conducted from January 1961 through May 2023 and yielded 4,612 articles, of which 312 were selected for comprehensive review after eliminating duplicates and nonfocused articles. RESULTS There has been an evident progressive shift from the role of peripheral factors, such as dental occlusion, to more central factors, such as the involvement of a central pattern generator as well as the autonomic nervous system, in the genesis of bruxing movements. There is continued robust interest in the dental community to elucidate the contributing factors involved in SB. CONCLUSIONS AND PRACTICAL IMPLICATIONS The neurophysiology of SB appears to be leaning more toward central rather than peripheral factors. There is increasing evidence of the role of the autonomic nervous system, genetics, and comorbidities in the genesis of SB. The scientific literature seems to refute the role of dental occlusion in the causation of bruxing movements. As per the literature, there has been a paradigm shift in the definition and genesis of SB and its possible dental implications and management, which also highlights the need for succinct scientific studies in this regard.
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Iizumi A, Tanaka S, Takaba M, Miyoshi K, Nakazato Y, Baba K. Three-dimensional evaluation of sleep bruxism-related splint wear using a dental laboratory scanner: A preliminary clinical study. J Oral Rehabil 2023; 50:122-130. [PMID: 36427256 DOI: 10.1111/joor.13394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/04/2022] [Accepted: 10/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The wear depth on the occlusal splint (OS) is reportedly associated with the sleep bruxism (SB) level, as evaluated using portable polysomnography (PSG) recordings. However, the OS is deformed owing to SB forces, possibly preventing the accurate quantification of the wear facets. OBJECTIVES We aimed to introduce a newly developed system to quantify the wear facets on the OS using a dental laboratory scanner (D810) and investigate the association between the wear facets, as evaluated with this system, and the SB level. METHODS Ten healthy individuals who were diagnosed with SB based on portable PSG recordings participated in this study. They were asked to wear the OS for 2 months. The first day after a 2-week adaptation period was defined as the reference day, and sequential scanning of the OS surface was performed on days 15, 30, and 45. Changes in the OS surface from the reference day allowed dimensional evaluation of the wear facets in terms of maximum wear depth, wear area, and wear volume. Multiple regression analyses were conducted to test whether each of these variables could be predicted by any of the SB-related variables. RESULTS The total duration of SB episodes per hour of sleep and the maximum muscle activity were significantly associated with the wear area, as measured with our system (adjusted R-squared was .78, p < .01). CONCLUSION Our system allows dimensional analysis of the wear facets on the OS surface in association with the SB level.
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Affiliation(s)
- Ai Iizumi
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Shinpei Tanaka
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Masayuki Takaba
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Keita Miyoshi
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Yukari Nakazato
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Kazuyoshi Baba
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
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Abe Y, Nakazato Y, Takaba M, Kawana F, Baba K, Kato T. Diagnostic accuracy of ambulatory polysomnography with electroencephalogram for detection of sleep bruxism-related masticatory muscle activity. J Clin Sleep Med 2023; 19:379-392. [PMID: 36305587 PMCID: PMC9892741 DOI: 10.5664/jcsm.10344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVES This study investigated the diagnostic accuracy of Sleep Profiler, which relies on ambulatory polysomnography (PSG) with electroencephalogram for sleep bruxism (SB) and examined its episode-by-episode agreement in comparison to PSG equipped with audiovisual recordings (avPSG). METHODS This prospective 2-gate study recruited 10 individuals with probable SB and 10 healthy volunteers. Overnight experimental recordings were performed simultaneously using the ambulatory PSG with masseter electromyography and avPSG with masseter and temporalis electromyography. Sleep staging was performed manually for avPSG and automatically or manually for ambulatory PSG. SB episodes were manually scored based on electromyography signals with reference to sleep stages. The episode-by-episode agreement was analyzed by setting avPSG as the reference standard. The sensitivity, specificity, and accuracy for the diagnosis of SB were calculated after optimizing the cutoff values of the episode index and the burst index. RESULTS Regarding the episode-by-episode agreement, median sensitivities were 0.825 and positive predictive values were approximately 0.6, regardless of the sleep staging procedure, indicating that approximately 40% of the overall total SB episodes scored by the ambulatory PSG were false positives. Because of overestimation of SB episodes, the optimal cutoff values for the episode index and the burst index were approximately 1.5 times higher than the avPSG-based cutoff values and dramatically improved the diagnostic precision metrics for the ambulatory PSG. CONCLUSIONS Sleep Profiler can eliminate events during wakefulness by electroencephalogram and may provide a definitive diagnosis in patients with possible SB by applying optimized cutoff values. However, the risk of overestimation must be recognized. CLINICAL TRIAL REGISTRATION Registry: UMIN Clinical Trials Registry; Name: Accuracy of Portable PSG Device for Detection of Sleep Bruxism-Related Masseter EMG Muscle Activity; URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037380; Identifier: UMIN000032793. CITATION Abe Y, Nakazato Y, Takaba M, Kawana F, Baba K, Kato T. Diagnostic accuracy of ambulatory polysomnography with electroencephalogram for detection of sleep bruxism-related masticatory muscle activity. J Clin Sleep Med. 2023;19(2):379-392.
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Affiliation(s)
- Yuka Abe
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Yukari Nakazato
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Masayuki Takaba
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Fusae Kawana
- Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazuyoshi Baba
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
- Sleep Medicine Center, Osaka University Hospital, Osaka, Japan
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Electromyographic Assessment of Masseter Muscle Activity: A Proposal for a 24 h Recording Device with Preliminary Data. J Clin Med 2022; 12:jcm12010247. [PMID: 36615048 PMCID: PMC9821195 DOI: 10.3390/jcm12010247] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/17/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The instrumental measurement of electromyographic (EMG) activity in the natural environment is the best strategy available to collect information on bruxism. The twofold aim of this study was to (1) introduce and discuss a novel EMG device for the assessment of awake (AB) and sleep bruxism (SB) in the home environment over 24 h and (2) present some preliminary data. METHODS Fifteen healthy volunteers (eight males and seven females; mean age: 48.2 ± 4.1 years) underwent 24 h EMG recording trials of their masseter muscle activity (MMA) with a miniaturized wireless device. This device allowed us to measure the durations of the different phases of the recordings (total duration, awake time, sleep time, and electrode dislodgement time) as well as the bruxism time index (BTI) and bruxism work index (BWI) for both the waking and sleeping hours. RESULTS For the healthy volunteers, on average, the bruxism work index (BWI) values were 0.4 ± 0.2 and 0.1 ± 0.1 for awake and sleep, respectively, while the mean bruxism time index (BTI) values were 0.9 ± 0.5 for awake and 0.3 ± 0.1 for sleep. CONCLUSIONS This investigation describes the technical features of a novel EMG recording device that permits the evaluation of masseter muscle activity in the home environment over 24 h. For the first time, a dedicated elaboration of the EMG signal allowed an assessment of muscle work and not just a count of purported SB/EMG events. CLINICAL SIGNIFICANCE Based on the multidisciplinary approach in the study of bruxism, such a methodology, thanks to its peculiar features, will allow researchers and clinicians to monitor the epidemiology of MMA and delve deeper into the awake and sleep bruxism correlates for tailored management in clinical settings.
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Mikami S, Yamaguchi T, Saito M, Nakajima T, Maeda M, Gotouda A. Validity of clinical diagnostic criteria for sleep bruxism by comparison with a reference standard using masseteric electromyogram obtained with an ultraminiature electromyographic device. Sleep Biol Rhythms 2022; 20:297-308. [PMID: 38469259 PMCID: PMC10899952 DOI: 10.1007/s41105-021-00370-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]
Abstract
Evaluation of sleep bruxism (SB) in clinical practice is currently conducted based on clinical findings, i.e., clinical diagnostic criteria consisting of medical interview, findings of tooth wear, and symptoms of temporomandibular joint (TMJ) and muscles. However, there are many unclear points about validity of the criteria. In this study, validity tests were conducted to clarify the accuracy of the clinical diagnostic criteria for SB by comparison with a reference standard using a single-channel masseteric electromyogram (EMG) obtained with ultraminiature electromyographic devices. The subjects included 30 'probable' bruxers (P-bruxers) who were clinically diagnosed as having SB and 30 non-bruxers. EMG was recorded during sleep under unrestrained and accustomed condition at each subject's home using ultraminiature cordless EMG devices. Bursts with amplitudes of more than 5%, 10%, 20% of the maximum voluntary contraction (MVC) value (EMG-burst-5%, EMG-burst-10%, and EMG-burst-20%) and episodes of sleep bruxism (EMG-episode) were selected for analyses. In all conditions for burst selection, the P-bruxer group showed a significantly larger number of bursts and episodes than those in the non-bruxer group. Accuracy of the clinical diagnosis criteria was 66.7% with the reference standard using EMG-burst-5%/h and 58.3% with that using EMG-episodes/h. By applying single-channel EMG as the reference standard, we were able to conduct validity tests of clinical diagnostic criteria with a larger sample. It was clarified that the level of accuracy of clinical diagnostic criteria for SB were not high despite using the combination of an interview and clinical findings.
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Affiliation(s)
- Saki Mikami
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648 Japan
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Kita 13 Nishi 7, Kita-ku, Sapporo, 060-8586 Japan
| | - Miku Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Kita 13 Nishi 7, Kita-ku, Sapporo, 060-8586 Japan
| | - Toshinori Nakajima
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648 Japan
| | - Masana Maeda
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648 Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648 Japan
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Cerqueira TRDC, Batista SG, de Mello EB, DosSantos MF, Tuñas ITDC. Impact of the COVID-19 Pandemic on Stress, Sleep, and Oral Health in University Students. FRONTIERS IN PAIN RESEARCH 2021; 2:744264. [PMID: 35295424 PMCID: PMC8915617 DOI: 10.3389/fpain.2021.744264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/28/2021] [Indexed: 12/12/2022] Open
Abstract
Background: The COVID-19 pandemic, a disease caused by Sars-CoV-2, has become a worldwide stressor, especially as it represents a new viral infection, which spreads quickly and easily, without prior knowledge about vaccination, and absence, to this moment, of a medication that is totally effective against the disease.Objective: The aim of this observational study was to provide a general evaluation, through a questionnaire applied to students in the health field of the Federal University of Rio de Janeiro, on the psychological impacts and behavioral changes generated by the COVID-19 pandemic on oral health, especially the triggering or exacerbation of bruxism and temporomandibular disorders (TMD).Methods: In order to verify the impacts of the pandemic on the health of UFRJ healthcare students, a non-randomized survey was performed with 370 students.Results: It was found that 72% of the students had their sleep routine altered, 65% had greater difficulty in keeping their spirits up, there was a statistically significant increase in emotional stress, headaches, and daytime teeth clenching.Conclusion: It was possible to conclude that the outbreak of COVID-19 resulted in psychological, physiological and behavioral impacts on students.
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Affiliation(s)
- Thaissa Reis do Carmo Cerqueira
- Prosthodontics and Materials Sciences Department, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Sayene Garcia Batista
- Prosthodontics and Materials Sciences Department, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Elson Braga de Mello
- Prosthodontics and Materials Sciences Department, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcos Fabio DosSantos
- Prosthodontics and Materials Sciences Department, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Postgraduate Program in Medicine (Radioloy), Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- *Correspondence: Marcos Fabio DosSantos ;
| | - Inger Teixeira de Campos Tuñas
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Imai H, Haraki S, Tsujisaka A, Okura M, Adachi H, Ohno Y, Yatani H, Kato T. A lack of specific motor patterns between rhythmic/non-rhythmic masticatory muscle activity and bodily movements in sleep bruxism. J Prosthodont Res 2021; 65:415-420. [PMID: 33281172 DOI: 10.2186/jpr.jpr_d_20_00012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose The aims of the present study were to investigate the temporal relationships between jaw and bodily movements and clarify motor processes in the genesis of rhythmic masticatory muscle activity (RMMA) in sleep bruxism (SB).Methods Video-polysomnography recordings were obtained from ten subjects with SB (mean age: 23.4 ± 1.6 years) and ten matched normal controls (CTL) (mean age: 24.4 ± 3.2 years). RMMA and nonspecific masseter activity (NSMA) were scored in association with bodily movements in the leg, arm, head, and trunk using electromyography and video recordings. The relationship between oromotor episodes and bodily movements was assessed in terms of sleep stage distributions and temporal relationships. Cardiac changes preceding oromotor episodes in stage N2 were assessed.Results Approximately 80% of RMMA and NSMA were associated with movements in one or more body sites. RMMA and NSMA were more frequently associated with movements of the leg (70-75%) and arm (40-55%) than movements of the head (17-22%) and trunk (5-25%). The relationship between oromotor episodes and bodily movements did not significantly differ among sleep stages. Oromotor episodes and bodily movements did not show a consistent temporal pattern in the SB and CTL groups. Regardless of the temporal relationship between oromotor episodes and bodily movements, the mean heart rate significantly increased by 5 beats before the onset of oromotor episodes.Conclusions No specific temporal motor patterns were found between RMMA and bodily movements. RMMA and NSMA represent a repertoire of arousal-related autonomic motor responses during sleep.
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Affiliation(s)
- Hideto Imai
- Faculty of Nursing, Setsunan University, Osaka, Japan
| | - Shingo Haraki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Akiko Tsujisaka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Mutsumi Okura
- Center for Sleep Medicine, Department of Neurology Asahi University Hospital, Gifu, Japan.,Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiroyoshi Adachi
- Health and Counseling Center, Osaka University, Osaka, Japan.,Sleep Medicine Center, Osaka University Hospital, Osaka, Japan
| | - Yuko Ohno
- Department of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan.,Sleep Medicine Center, Osaka University Hospital, Osaka, Japan
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11
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Thymi M, Lobbezoo F, Aarab G, Ahlberg J, Baba K, Carra MC, Gallo LM, De Laat A, Manfredini D, Lavigne G, Svensson P. Signal acquisition and analysis of ambulatory electromyographic recordings for the assessment of sleep bruxism: A scoping review. J Oral Rehabil 2021; 48:846-871. [PMID: 33772835 PMCID: PMC9292505 DOI: 10.1111/joor.13170] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/07/2021] [Accepted: 03/17/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Ambulatory electromyographic (EMG) devices are increasingly being used in sleep bruxism studies. EMG signal acquisition, analysis and scoring methods vary between studies. This may impact comparability of studies and the assessment of sleep bruxism in patients. OBJECTIVES (a) To provide an overview of EMG signal acquisition and analysis methods of recordings from limited-channel ambulatory EMG devices for the assessment of sleep bruxism; and (b) to provide an overview of outcome measures used in sleep bruxism literature utilising such devices. METHOD A scoping review of the literature was performed. Online databases PubMed and Semantics Scholar were searched for studies published in English until 7 October 2020. Data on five categories were extracted: recording hardware, recording logistics, signal acquisition, signal analysis and sleep bruxism outcomes. RESULTS Seventy-eight studies were included, published between 1977 and 2020. Recording hardware was generally well described. Reports of participant instructions in device handling and of dealing with failed recordings were often lacking. Basic elements of signal acquisition, for example amplifications factors, impedance and bandpass settings, and signal analysis, for example rectification, signal processing and additional filtering, were underreported. Extensive variability was found for thresholds used to characterise sleep bruxism events. Sleep bruxism outcomes varied, but typically represented frequency, duration and/or intensity of masticatory muscle activity (MMA). CONCLUSION Adequate and standardised reporting of recording procedures is highly recommended. In future studies utilising ambulatory EMG devices, the focus may need to shift from the concept of scoring sleep bruxism events to that of scoring the whole spectrum of MMA.
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Affiliation(s)
- Magdalini Thymi
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry AmsterdamUniversity of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry AmsterdamUniversity of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry AmsterdamUniversity of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial DiseasesUniversity of HelsinkiHelsinkiFinland
| | - Kazuyoshi Baba
- Department of ProsthodonticsShowa University School of DentistryOhta‐kuJapan
| | - Maria Clotilde Carra
- UFR of Odontology GaranciereUniversité de Paris and Service of OdontologyRothschild Hospital (AP‐HP)ParisFrance
| | - Luigi M. Gallo
- Clinic of Masticatory DisordersCenter of Dental MedicineUniversity of ZurichZurichSwitzerland
| | - Antoon De Laat
- Department of Oral Health SciencesLeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenLeuvenBelgium
- Department of DentistryUniversity HospitalLeuvenBelgium
| | - Daniele Manfredini
- Department of Biomedical TechnologiesSchool of DentistryUniversity of SienaSienaItaly
| | - Gilles Lavigne
- Faculty of Dental MedicineUniversité de MontréalMontrealQCCanada
- CIUSSS Nord Ile de MontrealCenter for Advance Research in Sleep Medicine & StomatologyCHUM, MontrealQCCanada
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral HealthAarhus Universitet TandlageskolenAarhusDenmark
- Faculty of OdontologyMalmø UniversityMalmøSweden
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12
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Nakazato Y, Takaba M, Abe Y, Nakamura H, Ohara H, Suganuma T, Clark GT, Baba K. Effect of contingent vibratory stimulus via an oral appliance on sleep bruxism after the splint adaptation period. J Oral Rehabil 2021; 48:901-908. [PMID: 33983628 DOI: 10.1111/joor.13182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/27/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Contingent vibratory feedback stimuli applied by a specially designed oral appliance (OA) have been reported to be effective in reducing sleep bruxism (SB). However, the inhibitory effects of the OA, which occur immediately after OA delivery, may have confounded this finding. OBJECTIVE This study sought to shed light on the effects of vibratory stimuli on SB after the OA adaptation period, when its inhibitory effects are diminished. METHODS Fourteen 'definite' SB patients were enrolled. A force-based bruxism detection system was utilised to trigger a vibrator attached to the OA. Masseter electromyographic activity during sleep was recorded at home using portable polysomnography. After using the OA without vibratory stimulus for 16 nights (adaptation period), intermittent vibratory stimuli were applied every other half-hour for four nights (intervention period). Electromyographic activity over 10% of the maximum voluntary contraction was regarded as a SB episode. The number and the total duration of SB episodes per hour of sleep were calculated for the sessions with and without stimuli separately and averaged for four intervention nights. The effects of stimuli on these two variables were evaluated. RESULTS The number and the total duration of the sessions without stimuli were 5.2 episodes/h and 35.3 s/h, respectively. These values significantly decreased to 3.9 episodes/h and 15.1 s/h (p < .05) for the sessions with vibratory stimuli. CONCLUSION Contingent vibratory stimulus via an OA may be effective for the management of SB even after adaptation to OA.
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Affiliation(s)
- Yukari Nakazato
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Masayuki Takaba
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Yuka Abe
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Hirotaka Nakamura
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Hironobu Ohara
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Takeshi Suganuma
- Division of Temporomandibular Disorders and Orofacial Pain, Department of Special Needs Dentistry, School of Dentistry, Showa University, Tokyo, Japan
| | - Glenn T Clark
- Orofacial Pain and Oral Medicine Center and Distance Learning Office, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Kazuyoshi Baba
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
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13
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Lavigne G, Kato T, Herrero Babiloni A, Huynh N, Dal Fabbro C, Svensson P, Aarab G, Ahlberg J, Baba K, Carra MC, Cunha TCA, Gonçalves DAG, Manfredini D, Stuginski-Barbosa J, Wieckiewicz M, Lobbezoo F. Research routes on improved sleep bruxism metrics: Toward a standardised approach. J Sleep Res 2021; 30:e13320. [PMID: 33675267 DOI: 10.1111/jsr.13320] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 12/17/2022]
Abstract
A recent report from the European Sleep Research Society's task force "Beyond AHI" discussed an issue that has been a long-term subject of debate - what are the best metrics for obstructive sleep apnoea (OSA) diagnosis and treatment outcome assessments? In a similar way, sleep bruxism (SB) metrics have also been a recurrent issue for >30 years and there is still uncertainty in dentistry regarding their optimisation and clinical relevance. SB can occur alone or with comorbidities such as OSA, gastroesophageal reflux disorder, insomnia, headache, orofacial pain, periodic limb movement, rapid eye movement behaviour disorder, and sleep epilepsy. Classically, the diagnosis of SB is based on the patient's dental and medical history and clinical manifestations; electromyography is used in research and for complex cases. The emergence of new technologies, such as sensors and artificial intelligence, has opened new opportunities. The main objective of the present review is to stimulate the creation of a collaborative taskforce on SB metrics. Several examples are available in sleep medicine. The development of more homogenised metrics could improve the accuracy and refinement of SB assessment, while moving forward toward a personalised approach. It is time to develop SB metrics that are relevant to clinical outcomes and benefit patients who suffer from one or more possible negative consequences of SB.
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Affiliation(s)
- Gilles Lavigne
- Faculty of Dental Medicine, Universite de Montreal & CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada
| | - Takafumi Kato
- Department of Oral Physiology Graduate School of Dentistry, Sleep Medicine Center, Osaka University Hospital, Osaka University, Suita, Japan
| | - Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, QC, Canada.,CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine, Montreal, QC, Canada
| | - Nelly Huynh
- Faculty of Dental Medicine, Universite de Montreal and CHU Saint-Justine Research Center, Montreal, QC, Canada
| | - Cibele Dal Fabbro
- Faculty of Dental Medicine, Universite de Montreal & CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Faculty of Odontology, Malmø University, Malmø, Sweden
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Kazuyoshi Baba
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Maria Clotilde Carra
- UFR of Odontology Garanciere, Université de Paris and Service of Odontology, Rothschild Hospital (AP-HP), Paris, France
| | - Thays Crosara A Cunha
- Department of Genetics and Biochemistry, Federal University of Uberlandia, Uberlandia, Brazil
| | - Daniela A G Gonçalves
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (Unesp), Araraquara, Brazil
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | | | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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14
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Martinot JB, Le-Dong NN, Cuthbert V, Denison S, Gozal D, Lavigne G, Pépin JL. Artificial Intelligence Analysis of Mandibular Movements Enables Accurate Detection of Phasic Sleep Bruxism in OSA Patients: A Pilot Study. Nat Sci Sleep 2021; 13:1449-1459. [PMID: 34466045 PMCID: PMC8397703 DOI: 10.2147/nss.s320664] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/05/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Sleep bruxism (SBx) activity is classically identified by capturing masseter and/or temporalis masticatory muscles electromyographic activity (EMG-MMA) during in-laboratory polysomnography (PSG). We aimed to identify stereotypical mandibular jaw movements (MJM) in patients with SBx and to develop rhythmic masticatory muscles activities (RMMA) automatic detection using an artificial intelligence (AI) based approach. PATIENTS AND METHODS This was a prospective, observational study of 67 suspected obstructive sleep apnea (OSA) patients in whom PSG with masseter EMG was performed with simultaneous MJM recordings. The system used to collect MJM consisted of a small hardware device attached on the chin that communicates to a cloud-based infrastructure. An extreme gradient boosting (XGB) multiclass classifier was trained on 79,650 10-second epochs of MJM data from the 39 subjects with a history of SBx targeting 3 labels: RMMA episodes (n=1072), micro-arousals (n=1311), and MJM occurring at the breathing frequency (n=77,267). RESULTS Validated on unseen data from 28 patients, the model showed a very good epoch-by-epoch agreement (Kappa = 0.799) and balanced accuracy of 86.6% was found for the MJM events when using RMMA standards. The RMMA episodes were detected with a sensitivity of 84.3%. Class-wise receiver operating characteristic (ROC) curve analysis confirmed the well-balanced performance of the classifier for RMMA (ROC area under the curve: 0.98, 95% confidence interval [CI] 0.97-0.99). There was good agreement between the MJM analytic model and manual EMG signal scoring of RMMA (median bias -0.80 events/h, 95% CI -9.77 to 2.85). CONCLUSION SBx can be reliably identified, quantified, and characterized with MJM when subjected to automated analysis supported by AI technology.
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Affiliation(s)
- Jean-Benoit Martinot
- Sleep Laboratory, CHU Université Catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, 5000, Belgium.,Institute of Experimental and Clinical Research, UCL Bruxelles Woluwe, Brussels, 1200, Belgium
| | | | - Valérie Cuthbert
- Sleep Laboratory, CHU Université Catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, 5000, Belgium
| | | | - David Gozal
- Department of Child Health and Child Health Research Institute, University of Missouri, Columbia, MO, 65201, USA
| | - Gilles Lavigne
- Faculté de médecine dentaire, Université de Montréal, Montréal, Québec, H3C 3J7, Canada
| | - Jean-Louis Pépin
- HP2 Laboratory, Inserm U1042, University Grenoble Alpes, Grenoble, 38000, France
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15
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Aarab G, Arcache P, Lavigne GJ, Lobbezoo F, Huynh N. The effects of mandibular advancement appliance therapy on jaw-closing muscle activity during sleep in patients with obstructive sleep apnea: a 3-6 months follow-up. J Clin Sleep Med 2020; 16:1545-1553. [PMID: 32501212 DOI: 10.5664/jcsm.8612] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVES The main aim of this study was to investigate the effects of mandibular advancement appliance (MAA) therapy on jaw-closing muscle activity (JCMA) time-related to respiratory arousals, and on JCMA time-related to nonrespiratory arousals in patients with obstructive sleep apnea. METHODS Eighteen patients with OSA (mean ± standard deviation = 49.4 ± 9.8 years) with a mean ± standard deviation apnea-hypopnea index of 22.0 ± 16.0 events/h of sleep participated in a randomized controlled crossover trial in which two ambulatory polysomnographic recordings, 1 with an MAA in situ and another without the MAA in situ, were performed. JCMA was quantified as the sum of rhythmic masticatory muscle activities and other orofacial activities. RESULTS Significant reductions in the apnea-hypopnea index (Z = -2.984; P = .003), in the respiratory arousal index (Z = -2.896; P = .004), and in the JCMA time-related to respiratory arousal index (Z = -3.434; P = .001) were found with MAA in situ. On the nonrespiratory arousal index, and on the JCMA time-related to nonrespiratory arousal index, MAA had no significant effect (T = 2.23; P = .82; and Z = -0.66; P = .51, respectively). CONCLUSIONS This study shows that effective mandibular advancement appliance therapy significantly reduces jaw-closing muscle activities time-related to respiratory arousals in OSA patients. Future studies are needed to confirm these findings in obstructive sleep apnea patients with comorbid sleep bruxism. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: The Effects of Oral Appliance Therapy on Masseter Muscle Activity in Obstructive Sleep Apnea; Identifier: NCT02011425.
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Affiliation(s)
- Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
| | - Patrick Arcache
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
| | - Gilles J Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nelly Huynh
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
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16
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Zeng X, Wang Y, Dong Q, Ma MX, Liu Q, Tan JG. [Study on the correlation between the mandibular masticatory muscle movement and sleep tooth wear]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:54-58. [PMID: 32037767 DOI: 10.7518/hxkq.2020.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the correlation between the clinical diagnostic criteria of sleep bruxism and the frequency of mandibular movements during sleep. METHODS Video polysomnography was used to record 20 healthy adults with at least one of the following clinical symptoms and signs: 1) report of frequent tooth grinding; 2) tooth wear and dentin exposure with at least three occlusal surfaces; 3) masticatory muscle symptoms in the morning; 4) masseter muscle hypertrophy. The rhythmic masticatory muscle activity (RMMA) and isolated tonic activity were scored to compare the correlations with clinical symptoms and signs. Finally, the incidence of temporomandibular disorders (TMD) was investigated in patients with isolated tonic and RMMA subjects. RESULTS Among the 20 subjects, RMMA events were observed (5.8±3.1) times·h⁻¹ and isolated tonic episodes were observed (2.1±0.9) times·h⁻¹. The frequency of RMMA events was significantly greater in the patients with acoustic molars than in those without (P<0.05). Similarly, the frequency of RMMA events was significantly greater in the patients with tooth attrition than in those without (P<0.05). However, no difference was observed between the occurrence of RMMA and the symptoms of masticatory muscles or masseter hypertrophy in the morning. The incidence of TMD was significantly higher in the patients with RMMA than in the isolated tonic patients. CONCLUSIONS The clinical symptoms and signs often used to diagnose sleep bruxism are different clinical and physiological mandibular movements during sleep. RMMA during sleep can reflect the occurrence of tooth attrition and the high risk of TMD.
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Affiliation(s)
- Xiao Zeng
- Dept. of Prosthodontics and Implant, Stomatological Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Yong Wang
- Dept. of Prosthodontics and Implant, Stomatological Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Qiang Dong
- Dept. of Prosthodontics and Implant, Stomatological Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Min-Xian Ma
- Dept. of Prosthodontics and Implant, Stomatological Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Qin Liu
- Dept. of Prosthodontics and Implant, Stomatological Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Jian-Guo Tan
- Dept. of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
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17
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Maeda M, Yamaguchi T, Mikami S, Yachida W, Saito T, Sakuma T, Nakamura H, Saito M, Mizuno M, Yamada K, Satoh K. Validity of single-channel masseteric electromyography by using an ultraminiature wearable electromyographic device for diagnosis of sleep bruxism. J Prosthodont Res 2020; 64:90-97. [DOI: 10.1016/j.jpor.2019.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 03/25/2019] [Accepted: 04/02/2019] [Indexed: 11/16/2022]
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18
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Miki H, Minakuchi H, Miyagi M, Hara ES, Shigemoto S, Suzuki Y, Maekawa K, Matsuka Y, Clark GT, Kuboki T. Association of masticatory muscle activity with sleep arousal and other concomitant movements during sleep. J Oral Rehabil 2019; 47:281-288. [DOI: 10.1111/joor.12913] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/23/2019] [Accepted: 11/14/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Haruna Miki
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Hajime Minakuchi
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Mayu Miyagi
- Department of Stomatgnathic Function and Occlusal Reconstruction Institute of Biomedical Sciences Clinical Dentistry Tokushima University Graduate School Tokushima Japan
| | - Emilio Satoshi Hara
- Department of Biomaterials Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Shuji Shigemoto
- Department of Fixed Prosthodontics School of Dental Medicine Tsurumi University Yokohama Japan
| | - Yoshitaka Suzuki
- Department of Stomatgnathic Function and Occlusal Reconstruction Institute of Biomedical Sciences Clinical Dentistry Tokushima University Graduate School Tokushima Japan
| | - Kenji Maekawa
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Yoshizo Matsuka
- Department of Stomatgnathic Function and Occlusal Reconstruction Institute of Biomedical Sciences Clinical Dentistry Tokushima University Graduate School Tokushima Japan
| | - Glenn T. Clark
- Advanced Program in Orofacial Pain and Oral Medicine Ostrow School of DentistryUniversity of Southern California Los Angeles CA USA
| | - Takuo Kuboki
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
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19
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Maeda M, Yamaguchi T, Mikami S, Yachida W, Saito T, Sakuma T, Nakamura H, Saito M, Mizuno M, Yamada K, Satoh K. Quantitative analyses of jaw-opening muscle activity during the active phase of jaw-closing muscles in sleep bruxism. J Sleep Res 2019; 29:e12922. [PMID: 31573129 DOI: 10.1111/jsr.12922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/16/2019] [Accepted: 08/23/2019] [Indexed: 11/29/2022]
Abstract
Rhythmic masticatory muscle activity (RMMA), which is defined as three or more consecutive phasic bursts, accounts for a large part of sleep bruxism (SB). RMMA is thought to be characterized by co-contraction, a jaw muscle activity in which jaw-opening muscles contract during the active phase of jaw-closing muscles, which is different from that during mastication. However, there has been limited information about co-contraction. The aim of the present study was to clarify the amplitudes and patterns of jaw-opening muscle activity during the active phase of jaw-closing muscles in RMMA. Data from 14 healthy volunteers with bruxism, which was diagnosed by using polysomnographic recording with audio-video, were analysed. RMMA with electromyographic amplitudes of more than two times the baseline amplitude was selected. From the selected RMMA, burst groups consisting of five or more consecutive phasic bursts, including tonic bursts, were selected for analyses. Electromyographic activities during gum chewing were also recorded before sleeping. The minimum, maximum and average value of the amplitudes of jaw-opening muscle activity during the active phase of jaw-closing muscles were calculated. Jaw-opening muscle activity during the active phase of jaw-closing muscles in RMMA was closer to the baseline than that in gum chewing. The minimum, maximum and average values of amplitudes of jaw-opening muscle activity during the phase were significantly smaller than those of gum chewing. Contrary to our hypothesis prior to the study, the obtained results suggested that the pattern of electromyogram activity of jaw-opening and jaw-closing muscles in RMMA was not necessarily co-contraction.
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Affiliation(s)
- Masana Maeda
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Saki Mikami
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Wataru Yachida
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Taishi Saito
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Toshimitsu Sakuma
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hironobu Nakamura
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Miku Saito
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Mariko Mizuno
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kyoko Yamada
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kaoru Satoh
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
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Miettinen T, Myllymaa K, Muraja-Murro A, Westeren-Punnonen S, Hukkanen T, Töyräs J, Lappalainen R, Mervaala E, Sipilä K, Myllymaa S. Polysomnographic scoring of sleep bruxism events is accurate even in the absence of video recording but unreliable with EMG-only setups. Sleep Breath 2019; 24:893-904. [PMID: 31402440 PMCID: PMC7426313 DOI: 10.1007/s11325-019-01915-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/25/2019] [Accepted: 08/02/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To determine the accuracy of scoring masticatory muscle activity (MMA) events in seven different polysomnography (PSG) setups. METHODS Nineteen volunteers (13 females, 6 males, age 31.1 ± 12.9 years, 12 self-proclaimed bruxers) attended one-night PSG recording, supplemented with audio, video, and a separate frontal electroencephalography electrode set (FES). The same examiner scored the MMA events with seven different setups, with varying number of channels available: (1) one, (2) two, and (3) four EMG channels, (4) PSG without audio or video (PSG-N), (5) home PSG with FES and audio (FES-A), (6) PSG with audio (PSG-A), and (7) PSG with audio and video (PSG-AV). A subset (n = 10) of recordings was scored twice to determine intra-scorer reliability. MMA indices and accuracy of scoring the events in different setups were compared against PSG-AV. RESULTS The intra-class correlation coefficient (ICC) between PSG-AV and PSG-A was high (0.940, p < 0.001) as well as for FES-A (0.927, p < 0.001), whereas for PSG-N, it was lower (0.835, p < 0.001); for setups with only EMG channels, coefficients were very low (ICC < 0.100 for all). Intra-examiner reliability was high (ICC > 0.939 for all setups), with the exception of PSG-N (ICC = 0.764, p = 0.002). When comparing against the MMA events scored in PSG-AV, the sensitivity of MMA event recognition for PSG-A was 78.5% and specificity 95.5%, which were substantially higher than sensitivity (52.0%) and specificity (87.2%) of PSG-N. CONCLUSIONS MMA event scoring accuracy with PSG-A or FES-A is almost comparable to PSG-AV. Since precise event recognition is essential for accurate MMA scoring, it is evident that one cannot rely exclusively on EMG.
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Affiliation(s)
- Tomi Miettinen
- Department of Applied Physics, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland.
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.
- Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
| | - Katja Myllymaa
- Department of Applied Physics, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland
- Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Anu Muraja-Murro
- Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Susanna Westeren-Punnonen
- Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Taina Hukkanen
- Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland
- Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Reijo Lappalainen
- Department of Applied Physics, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland
| | - Esa Mervaala
- Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Kirsi Sipilä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sami Myllymaa
- Department of Applied Physics, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
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Nakamura H, Takaba M, Abe Y, Yoshizawa S, Suganuma T, Yoshida Y, Nakazato Y, Ono Y, Clark GT, Baba K. Effects of a contingent vibratory stimulus delivered by an intra-oral device on sleep bruxism: a pilot study. Sleep Breath 2019; 23:363-372. [DOI: 10.1007/s11325-019-01782-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 01/04/2019] [Accepted: 01/12/2019] [Indexed: 12/28/2022]
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22
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Kim S, Park KJ, Shim YJ, Kim ST. Botulinum Toxin Injection for Managing Sleep Bruxism. SLEEP MEDICINE RESEARCH 2018. [DOI: 10.17241/smr.2018.00199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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24
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Miettinen T, Myllymaa K, Westeren-Punnonen S, Ahlberg J, Hukkanen T, Toyras J, Lappalainen R, Mervaala E, Sipila K, Myllymaa S, Miettinen T, Myllymaa K, Westeren-Punnonen S, Ahlberg J, Hukkanen T, Toyras J, Lappalainen R, Mervaala E, Sipila K, Myllymaa S. Success Rate and Technical Quality of Home Polysomnography With Self-Applicable Electrode Set in Subjects With Possible Sleep Bruxism. IEEE J Biomed Health Inform 2017; 22:1124-1132. [PMID: 28829322 DOI: 10.1109/jbhi.2017.2741522] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Using sleep laboratory polysomnography (PSG) is restricted for the diagnosis of only the most severe sleep disorders due to its low availability and high cost. Home PSG is more affordable, but applying conventional electroencephalography (EEG) electrodes increases its overall complexity and lowers the availability. Simple, self-administered single-channel EEG monitors on the other hand suffer from poor reliability. In this study, we aimed to quantify the reliability of self-administrated home PSG recordings conducted with a newly designed ambulatory electrode set (AES) that enables multichannel EEG, electrooculography, electromyography, and electrocardiography recordings. We assessed the sleep study success rate and technical quality of the recordings performed in subjects with possible sleep bruxism (SB). Thirty-two females and five males aged 39.6 ± 11.6 years (mean±SD) with self-reported SB were recruited in the study. Self-administrated home PSG recordings with two AES designs were conducted (n = 19 and 21). The technical quality of the recordings was graded based on the proportion of interpretable data. Technical failure rate for AES (both designs) was 5% and SB was scorable for 96.9% of all recorded data. Only one recording failed due to mistakes in self-applying the AES. We found that the proportion of good quality self-administrated EEG recordings is significantly higher when multiple channels are used compared to using a single channel. Sleep study success rates and proportion of recordings with high quality interpretable data from EEG channels of AES were comparable to that of conventional home PSG. Self-applicable AES has potential to become a reliable tool for widely available home PSG.
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Miettinen T, Myllymaa K, Muraja‐Murro A, Westeren‐Punnonen S, Hukkanen T, Töyräs J, Lappalainen R, Mervaala E, Sipilä K, Myllymaa S. Screen‐printed ambulatory electrode set enables accurate diagnostics of sleep bruxism. J Sleep Res 2017; 27:103-112. [DOI: 10.1111/jsr.12536] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/09/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Tomi Miettinen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | - Katja Myllymaa
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | - Anu Muraja‐Murro
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | | | - Taina Hukkanen
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | - Juha Töyräs
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | - Reijo Lappalainen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Esa Mervaala
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
- Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
| | - Kirsi Sipilä
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Oral and Maxillofacial DepartmentKuopio University HospitalKuopioFinland
- Research Unit of Oral Health SciencesFaculty of MedicineUniversity of OuluOuluFinland
- Oral and Maxillofacial DepartmentMedical Research Center OuluOulu University HospitalOuluFinland
| | - Sami Myllymaa
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
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Yoshida Y, Suganuma T, Takaba M, Ono Y, Abe Y, Yoshizawa S, Sakai T, Yoshizawa A, Nakamura H, Kawana F, Baba K. Association between patterns of jaw motor activity during sleep and clinical signs and symptoms of sleep bruxism. J Sleep Res 2016; 26:415-421. [DOI: 10.1111/jsr.12481] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 10/23/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Yuya Yoshida
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Takeshi Suganuma
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Masayuki Takaba
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Yasuhiro Ono
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Yuka Abe
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Shuichiro Yoshizawa
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Takuro Sakai
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Ayako Yoshizawa
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Hirotaka Nakamura
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | | | - Kazuyoshi Baba
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
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27
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Sakai T, Kato T, Yoshizawa S, Suganuma T, Takaba M, Ono Y, Yoshizawa A, Yoshida Y, Kurihara T, Ishii M, Kawana F, Kiuchi Y, Baba K. Effect of clonazepam and clonidine on primary sleep bruxism: a double-blind, crossover, placebo-controlled trial. J Sleep Res 2016; 26:73-83. [DOI: 10.1111/jsr.12442] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 05/25/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Takuro Sakai
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Takafumi Kato
- Department of Oral Anatomy and Neurobiology; Graduate School of Dentistry; Osaka University; Suita Osaka Japan
- Sleep Medicine Center; Osaka University Hospital; Suita Osaka Japan
| | - Shuichiro Yoshizawa
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Takeshi Suganuma
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Masayuki Takaba
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Yasuhiro Ono
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Ayako Yoshizawa
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Yuya Yoshida
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Tatsuya Kurihara
- Department of Hospital Pharmaceutics; School of Pharmacy; Showa University; Tokyo Japan
| | - Masakazu Ishii
- Department of Pathophysiology; School of Pharmacy; Showa University; Tokyo Japan
| | | | - Yuji Kiuchi
- Department of Pharmacology; School of Medicine; Showa University; Tokyo Japan
| | - Kazuyoshi Baba
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
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28
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Yachida W, Arima T, Castrillon EE, Baad-Hansen L, Ohata N, Svensson P. Diagnostic validity of self-reported measures of sleep bruxism using an ambulatory single-channel EMG device. J Prosthodont Res 2016; 60:250-257. [PMID: 26876908 DOI: 10.1016/j.jpor.2016.01.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/14/2015] [Accepted: 01/16/2016] [Indexed: 11/13/2022]
Abstract
PURPOSE Self-reported measures have been widely used to indicate the presence of possible and probable sleep bruxism (SB) in both research and clinical situations. However, few studies have attempted to assess the diagnostic validity of this approach. The aim of this study was to estimate the diagnostic validity of self-reported measures of SB using an ambulatory single-channel electromyographic (EMG) device. METHODS A total of 115 participants were enrolled and examined by standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) including two questions related to SB: self-reported SB and morning-jaw symptoms. An ambulatory single-channel EMG device (GrindCare3™, Medotech A/S) was used for measuring jaw-muscle EMG activity during sleep for seven consecutive nights. Cut-off values for different measures of EMG activity (average, maximum and minimum) and the coefficient of variation (CV) were selected to divide participants into two groups, with higher or lower EMG activity or CV values. The sensitivity and specificity for each question and combination of them were calculated. RESULTS Self-reported SB had the highest sensitivity (compared with morning-jaw symptoms) for all measures of EMG activity and CV, although the values were low to modest (average: 76.0%, maximum: 76.9%, minimum: 77.3%, CV: 61.0%). The specificity was low for both the questions related to the different measures of EMG activity and CV (35.1-52.4%). CONCLUSIONS This study indicated that the diagnostic validity of self-reported measures of SB was low to modest using an ambulatory EMG device assessment as a reference. Using only self-reported measures for the assessment of SB may not have a high validity, which should be taken into consideration in the clinical evaluation of patients.
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Affiliation(s)
- Wataru Yachida
- Clinical Division of Crown and Bridge Prosthodontics Dentistry, Hokkaido University Hospital, Sapporo, Japan
| | - Taro Arima
- Division of International Affairs, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
| | - Eduardo E Castrillon
- Section of Orofacial Pain and Jaw Function, Department of Dentistry, Aarhus University, Aarhus, Denmark; Scandinavian Centre for Orofacial Neuroscience (SCON)
| | - Lene Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Department of Dentistry, Aarhus University, Aarhus, Denmark; Scandinavian Centre for Orofacial Neuroscience (SCON)
| | - Noboru Ohata
- Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry, Aarhus University, Aarhus, Denmark; Scandinavian Centre for Orofacial Neuroscience (SCON); Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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29
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Weak association between sleep bruxism and obstructive sleep apnea. A sleep laboratory study. Sleep Breath 2015; 20:703-9. [PMID: 26564168 DOI: 10.1007/s11325-015-1284-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 10/01/2015] [Accepted: 10/21/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE No definitive associations or causal relationships have been determined between obstructive sleep apnea-hypopnea (OSAH) and sleep bruxism (SB). The purpose of this study was to investigate, in a population reporting awareness of both OSAH and SB, the associations between each specific breathing and jaw muscle event. METHODS Polysomnography and audio-video data of 59 patients reporting concomitant OSAH and SB history were analyzed. Masseteric bursts after sleep onset were scored and classified into three categories: (1) sleep rhythmic masticatory muscle activity with SB (RMMA/SB), (2) sleep oromotor activity other than RMMA/SB (Sleep-OMA), and (3) wake oromotor activity after sleep onset (Wake-OMA). Spearman's rank correlation coefficient analyses were performed. Dependent variables were the number of RMMA/SB episodes, RMMA/SB bursts, Sleep-OMA, and Wake-OMA; independent variables were apnea-hypopnea index (AHI), arousal index(AI), body mass index(BMI), gender, and age. RESULTS Although all subjects had a history of both SB and OSAH, sleep laboratory results confirmed that these conditions were concomitant in only 50.8 % of subjects. Moderate correlations were found in the following combinations (p < 0.05); RMMA/SB episode with AI, RMMA/SB burst with AI and age, Sleep-OMA burst with AHI, and Wake-OMA burst with BMI. CONCLUSIONS The results suggest that (1) sleep arousals in patients with concomitant SB and OSAH are not strongly associated with onset of RMMA/SB and (2) apnea-hypopnea events appear to be related to higher occurrence of other types of sleep oromotor activity, and not SB activity. SB genesis and OSAH activity during sleep are probably influenced by different mechanisms.
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Ferraz O, de Moura Guimarães T, Maluly Filho M, Dal-Fabbro C, Abraão Crosara Cunha T, Cristina Lotaif A, Cristina Barros Schütz T, Santos-Silva R, Tufik S, Bittencourt L. Assessment of interobserver concordance in polysomnography scoring of sleep bruxism. Sleep Sci 2015; 8:121-3. [PMID: 26779318 PMCID: PMC4688588 DOI: 10.1016/j.slsci.2015.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 08/07/2015] [Accepted: 08/11/2015] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Objective evaluation of sleep bruxism (SB) using whole-night polysomnography (PSG) is relevant for diagnostic confirmation. Nevertheless, the PSG electromyogram (EMG) scoring may give rise to controversy, particularly when audiovisual monitoring is not performed. Therefore, the present study assessed the concordance between two independent scorers to visual SB on a PSG performed without audiovisual monitoring. METHODS Fifty-six PSG tests were scored from individuals with clinical history and polysomnography criteria of SB. In addition to the protocol of conventional whole-night PSG, electrodes were also placed bilaterally on the masseter and temporal muscles. Visual EMG scoring without audio video monitoring was scored by two independent scorers (Dentist 1 and Dentist 2) according the recommendations formulated in the AASM manual (2007). Kendall Tau correlation was used to assess interobserver concordance relative to variables "total duration of events (seconds), "shortest events", "longest events" and index in each phasic, tonic or mixed event. RESULTS The correlation was positive and significant relative to all the investigated variables, being T>0.54. CONCLUSION It was found a good inter-examiner concordance rate in SB scoring in absence of audio video monitoring.
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Affiliation(s)
- Otávio Ferraz
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, CEP 04021-002 Sao Paulo, Brazil
| | - Thais de Moura Guimarães
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, CEP 04021-002 Sao Paulo, Brazil
| | - Milton Maluly Filho
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, CEP 04021-002 Sao Paulo, Brazil
| | - Cibele Dal-Fabbro
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, CEP 04021-002 Sao Paulo, Brazil
| | - Thays Abraão Crosara Cunha
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, CEP 04021-002 Sao Paulo, Brazil
| | - Ana Cristina Lotaif
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, CEP 04021-002 Sao Paulo, Brazil
| | - Teresa Cristina Barros Schütz
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, CEP 04021-002 Sao Paulo, Brazil
| | - Rogério Santos-Silva
- Departamento de Pneumologia, Faculdade de Medicina da Universidade de São Paulo, Av.Dr. Enéas Carvalho Aguiar, 44, Cerqueira César, São Paulo, SP CEP 05403-000, Brazil
| | - Sergio Tufik
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, CEP 04021-002 Sao Paulo, Brazil
| | - Lia Bittencourt
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, CEP 04021-002 Sao Paulo, Brazil
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Grossi ML, Pattussi MP, Mainieri VC, Fagondes SC, Saueressig AC. Letter to the Editor. J Oral Rehabil 2015; 43:159-60. [PMID: 26432658 DOI: 10.1111/joor.12353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M L Grossi
- UFRGS, Porto Alegre, RS, Brazil.,University of Michigan, Ann Arbor, MI, USA.,University of Toronto, Toronto, ON, Canada.,Post-Graduate Program in Dentistry (Prosthodontics), Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - M P Pattussi
- Passo Fundo University, Passo Fundo, Brazil.,University College London, London, UK.,Public Health Graduate Program, Vale do Rio dos Sinos University, São Leopoldo, RS, Brazil
| | - V C Mainieri
- UFRGS, Porto Alegre, RS, Brazil.,Post-Graduate Program in Dentistry (Prosthodontics), Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.,Faculty of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - S C Fagondes
- UFRGS, Porto Alegre, RS, Brazil.,Pneumology Center, Sleep Laboratory, Clinical Hospital of Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - A C Saueressig
- UFRGS, Porto Alegre, RS, Brazil.,PUCRS, Porto Alegre, RS, Brazil.,Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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Singh PK, Alvi HA, Singh BP, Singh RD, Kant S, Jurel S, Singh K, Arya D, Dubey A. Evaluation of various treatment modalities in sleep bruxism. J Prosthet Dent 2015; 114:426-31. [DOI: 10.1016/j.prosdent.2015.02.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 02/24/2015] [Accepted: 02/24/2015] [Indexed: 10/23/2022]
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Carra MC, Huynh N, Fleury B, Lavigne G. Overview on Sleep Bruxism for Sleep Medicine Clinicians. Sleep Med Clin 2015; 10:375-84, xvi. [DOI: 10.1016/j.jsmc.2015.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sleep-associated aspects of myofascial pain in the orofacial area among Temporomandibular Disorder patients and controls. Sleep Med 2015; 16:1056-61. [PMID: 26298779 DOI: 10.1016/j.sleep.2015.03.022] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/10/2015] [Accepted: 03/31/2015] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVES To assess sleep-associated aspects of temporomandibular disorder (TMD) with myofascial pain (MP) in the orofacial area of patients and controls. MEASUREMENTS Three hundred five female patients were screened to find 44 participants fulfilling the inclusion criteria, 22 suffering from MP and 22 in a control group. Sleep quality was assessed by use of the Pittsburgh Sleep-Quality-Index (PSQI) and a validated German sleep questionnaire (SF-AR). Tooth wear was assessed and anterior temporalis muscle activity was measured at home for several nights by use of a portable electromyography (EMG) device. RESULTS 22 patients (45.0 ± 13.6 years) and 22 controls (45.2 ± 9.0 years) were recruited. The PSQI sum-score was 7.5 ± 3.7 for patients and 4.4 ± 3.0 for controls (p = 0.006). The SF-AR showed that 23% of the controls and 14% of the patients were "long sleepers". The overall number of episodes in the two groups was not significantly different (4.10 ± 2.65 versus 4.57 ± 1.99 episodes per hour). However, more patients had temporalis muscle activity possibly related to SB during all four consecutive nights (p = 0.04). According to the International Classification of Sleep Disorders - Third Edition (ICSD-3) criteria, 13.6% of the controls and 71.4% of the patients (p < 0.001) showed SB. CONCLUSIONS Sleep-associated disturbances, including reduction of sleep quality and greater prevalence of SB and facial pain in the morning, occurred significantly more often among TMD patients. Additionally, SB fluctuated over the nights especially in controls. This should be taken into consideration when the prevalence of SB is assessed by use of EMG.
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Lapointe E, Frenette É. Periodic or Rhythmic Movements During Sleep. Sleep Med Clin 2014. [DOI: 10.1016/j.jsmc.2014.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Diagnostic accuracy of sleep bruxism scoring in absence of audio-video recording: a pilot study. Sleep Breath 2014; 19:183-90. [DOI: 10.1007/s11325-014-0986-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 04/15/2014] [Accepted: 04/17/2014] [Indexed: 10/25/2022]
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Shim YJ, Lee MK, Kato T, Park HU, Heo K, Kim ST. Effects of botulinum toxin on jaw motor events during sleep in sleep bruxism patients: a polysomnographic evaluation. J Clin Sleep Med 2014; 10:291-8. [PMID: 24634627 DOI: 10.5664/jcsm.3532] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To investigate the effects of botulinum toxin type A (BoNT-A) injection on jaw motor episodes during sleep in patients with or without orofacial pain who did not respond to oral splint treatment. METHODS Twenty subjects with a clinical diagnosis of SB completed this study. Ten subjects received bilateral BoNT-A injections (25 U per muscle) into the masseter muscles only (group A), and the other 10 received the injections into both the masseter and temporalis muscles (group B). Video-polysomnographic (vPSG) recordings were made before and at 4 weeks after injection. Rhythmic masticatory muscle activity (RMMA) and orofacial activity (OFA) were scored and analyzed for several parameters (e.g., frequency of episodes, bursts per episode, episode duration). The peak amplitude of electromyographic (EMG) activity in the two muscles was also measured. RESULTS BoNT-A injection did not reduce the frequency, number of bursts, or duration for RMMA episodes in the two groups. The injection decreased the peak amplitude of EMG burst of RMMA episodes in the injected muscles (p < 0.001, repeated measure ANOVA) in both groups. At 4 weeks after injection, 9 subjects self-reported reduction of tooth grinding and 18 subjects self-reported reduction of morning jaw stiffness. CONCLUSIONS A single BoNT-A injection is an effective strategy for controlling SB for at least a month. It reduces the intensity rather than the generation of the contraction in jaw-closing muscles. Future investigations on the efficacy and safety in larger samples over a longer follow-up period are needed before establishing management strategies for SB with BoNT-A. CITATION Shim YJ; Lee MK; Kato T; Park HU; Heo K; Kim ST. Effects of botulinum toxin on jaw motor events during sleep in sleep bruxism patients: a polysomnographic evaluation.
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Affiliation(s)
- Young Joo Shim
- Department of Orofacial Pain and Oral Medicine, Daejeon Dental Hospital, College of Dentistry, Wonkwang University, Daejeon, Korea
| | - Moon Kyu Lee
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Takafumi Kato
- Department of Oral Anatomy and Neurobiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hyung Uk Park
- Department of Dentistry, Korea Army Training Center District Hospital, Nonsan, Korea
| | - Kyoung Heo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Taek Kim
- Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul, Korea
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Hasegawa Y, Lavigne G, Rompré P, Kato T, Urade M, Huynh N. Is there a first night effect on sleep bruxism? A sleep laboratory study. J Clin Sleep Med 2013; 9:1139-45. [PMID: 24235894 PMCID: PMC3805798 DOI: 10.5664/jcsm.3152] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sleep bruxism (SB) is reported to vary in frequency over time. The aim of this study was to assess the first night effect on SB. METHODS A retrospective polysomnographic (PSG) analysis was performed of data from a sample of SB patients (12 females, 4 males; age range: 17-39 years) recorded in a sleep laboratory over 2 consecutive nights. Sleep parameters and jaw muscle activity variables (i.e., rhythmic masticatory muscle activity [RMMA]) for SB were quantified and compared between the 2 nights. Subjects were classified into groups according to severity of RMMA frequency, such as low frequency (2-4 episodes/h and/or < 25 bursts/h) and moderate-high frequency (≥ 4 episodes/h and ≥ 25 bursts/h). RESULTS Overall, no first night effects were found for most sleep variables. However, total sleep time, sleep efficiency, and stage transitions showed significant time and group interactions (repeated measures ANOVAs, p ≤ 0.05). The RMMA episode index did not differ between the 2 nights, whereas the second night showed significantly higher burst index, bruxism time index, and mean burst duration (repeated measure ANOVAs, p ≤ 0.05). Five patients of 8 in the low frequency group were classified into the moderate-high frequency group on the second night, whereas only one patient in the moderate-high frequency group moved to the low frequency group. CONCLUSIONS The results showed no overall first night effect on severity of RMMA frequency in young and healthy patients with SB. In clinical practice, one-night sleep recording may be sufficient for moderate-high frequency SB patients. However, low RMMA frequency in the first night could be confirmed by a second night based on the patient's medical and dental history.
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Affiliation(s)
- Yoko Hasegawa
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya City, Hyogo, Japan
- Faculté de medicine dentaire, Université de Montréal, Montréal, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Gilles Lavigne
- Faculté de medicine dentaire, Université de Montréal, Montréal, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Pierre Rompré
- Faculté de medicine dentaire, Université de Montréal, Montréal, Canada
| | - Takafumi Kato
- Department of Oral Anatomy and Neurobiology, Graduate School of Dentistry, University of Osaka, Osaka, Japan
| | - Masahiro Urade
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya City, Hyogo, Japan
| | - Nelly Huynh
- Faculté de medicine dentaire, Université de Montréal, Montréal, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
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Saito M, Yamaguchi T, Mikami S, Watanabe K, Gotouda A, Okada K, Hishikawa R, Shibuya E, Lavigne G. Temporal association between sleep apnea-hypopnea and sleep bruxism events. J Sleep Res 2013; 23:196-203. [PMID: 24635459 DOI: 10.1111/jsr.12099] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 09/05/2013] [Indexed: 12/01/2022]
Abstract
There is some evidence suggesting that obstructive sleep apnea-hypopnea syndrome is concomitant with sleep bruxism. The aim of this study was to investigate the temporal association between sleep apnea-hypopnea 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 apnea-hypopnea 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 apnea-hypopnea events is a secondary form of sleep bruxism.
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Affiliation(s)
- Miku Saito
- Department of Gnatho-occlusal Function, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
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Castroflorio T, Mesin L, Tartaglia GM, Sforza C, Farina D. Use of Electromyographic and Electrocardiographic Signals to Detect Sleep Bruxism Episodes in a Natural Environment. IEEE J Biomed Health Inform 2013; 17:994-1001. [DOI: 10.1109/jbhi.2013.2274532] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Phasic jaw motor episodes in healthy subjects with or without clinical signs and symptoms of sleep bruxism: a pilot study. Sleep Breath 2013; 18:187-93. [DOI: 10.1007/s11325-013-0868-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 04/17/2013] [Accepted: 05/22/2013] [Indexed: 10/26/2022]
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Maluly M, Andersen M, Dal-Fabbro C, Garbuio S, Bittencourt L, de Siqueira J, Tufik S. Polysomnographic Study of the Prevalence of Sleep Bruxism in a Population Sample. J Dent Res 2013; 92:97S-103S. [DOI: 10.1177/0022034513484328] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The goal of the current study was to estimate the prevalence of sleep bruxism (SB) in the general population using a representative sample of 1,042 individuals who answered questionnaires and underwent polysomnography (PSG) examinations. After PSG, the individuals were classified into 3 groups: absence of SB, low-frequency SB, and high-frequency SB. The results indicated that the prevalence of SB, indicated by questionnaires and confirmed by PSG, was 5.5%. With PSG used exclusively as the criterion for diagnosis, the prevalence was 7.4% regardless of SB self-reported complaints. With questionnaires alone, the prevalence was 12.5%. Of the 5.5% (n = 56) with confirmed SB, 26 were classified as low-frequency SB, and 30 as high-frequency. The episodes of SB were more frequent in stage 2 sleep, and the phasic bruxism events were more frequent than tonic or mixed events in all sleep stages in individuals with SB. A positive association was observed between SB and insomnia, higher degree of schooling, and a normal/overweight body mass index (BMI). These findings demonstrate the prevalence of SB in a population sampled by PSG, the gold standard methodology in the investigation of sleep disorders, combined with validated questionnaires (ClinicalTrials.gov, NCT00596713).
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Affiliation(s)
- M. Maluly
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - M.L. Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - C. Dal-Fabbro
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - S. Garbuio
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - L. Bittencourt
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - J.T.T. de Siqueira
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - S. Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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Sleep less and bite more: Sleep disorders associated with occlusal loads during sleep. J Prosthodont Res 2013; 57:69-81. [DOI: 10.1016/j.jpor.2013.03.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 03/05/2013] [Accepted: 03/05/2013] [Indexed: 11/18/2022]
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Effects of the bite splint 15-day treatment termination in patients with temporomandibular disorder with a clinical history of sleep bruxism: a longitudinal single-cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:740-8. [DOI: 10.1016/j.oooo.2012.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 05/24/2012] [Accepted: 06/06/2012] [Indexed: 11/29/2022]
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Shedden Mora M, Weber D, Borkowski S, Rief W. Nocturnal masseter muscle activity is related to symptoms and somatization in temporomandibular disorders. J Psychosom Res 2012; 73:307-12. [PMID: 22980538 DOI: 10.1016/j.jpsychores.2012.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 07/17/2012] [Accepted: 07/17/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Temporomandibular disorders (TMD) have often been related to sleep bruxism and elevated nocturnal masseter muscle activity (NMMA). However, previous studies have revealed controversial results, and the role of somatization, depression and anxiety has not been studied in this context. The aim of this study was to investigate the association between NMMA and pain intensity, TMD related symptoms, somatoform symptoms, depression, and anxiety in chronic TMD. METHODS Thirty-six subjects with chronic painful TMD, 34 subjects with pain free bruxism, and 36 healthy controls recorded their nocturnal masseter muscle activity during three consecutive nights with portable devices. In addition, participants completed pain diaries and questionnaires. Diagnoses were established using the research diagnostic criteria for TMD. RESULTS Subjects with chronic TMD reported a reduced general health state (p<.001), higher levels of somatoform symptoms (p<.001), depression (p<.05), and anxiety (p<.001) compared to control subjects with or without sleep bruxism. The amount of NMMA did not differ significantly between the groups. In subjects with TMD, pain intensity was not related to NMMA. However, higher NMMA was related to higher intensity of jaw related symptoms such as headache or tinnitus, and higher somatization in general. CONCLUSION Chronic TMD is associated with elevated levels of psychopathology. These findings suggest a common link between NMMA, somatization, and symptom intensity in chronic TMD.
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Affiliation(s)
- Meike Shedden Mora
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Germany.
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47
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Cohen-Levy J, Pételle B, Pinguet J, Limerat E, Fleury B. Forces created by mandibular advancement devices in OSAS patients. Sleep Breath 2012; 17:781-9. [DOI: 10.1007/s11325-012-0765-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 08/11/2012] [Accepted: 08/20/2012] [Indexed: 11/28/2022]
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Validation of the Bitestrip versus polysomnography in the diagnosis of patients with a clinical history of sleep bruxism. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:612-7. [DOI: 10.1016/j.oooo.2011.10.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 10/19/2011] [Accepted: 10/26/2011] [Indexed: 11/24/2022]
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Nashed A, Lanfranchi P, Rompré P, Carra MC, Mayer P, Colombo R, Huynh N, Lavigne G. Sleep bruxism is associated with a rise in arterial blood pressure. Sleep 2012; 35:529-36. [PMID: 22467991 PMCID: PMC3296795 DOI: 10.5665/sleep.1740] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Sleep bruxism (SB) is a movement disorder identified by grinding of teeth and rhythmic masticatory muscle activity (RMMA). RMMA is associated with body movements and cortical arousals. Increases in autonomic sympathetic activities that characterize sleep cortical arousal precede RMMA/SB. Based on these findings, this study examined whether RMMA/SB episodes are also associated with significant changes in arterial blood pressure (BP). DESIGN Participants underwent 3 nights of full polysomnography that included noninvasive beat-to-beat BP recording. Single RMMA/SB episodes and arousal episodes were analyzed in stage 2 sleep and categorized as: (i) RMMA/SB + arousal; (ii) RMMA/SB + body movement; (iii) RMMA/SB + arousal + body movement; or (iv) arousal alone. Sleep and RMMA/SB data were compared to a Non SB group. RMMA/SB clusters (RMMA/SB episodes ≤ 30 sec apart) were also analyzed. SETTING Sleep Laboratory at l'Hôpital du Sacré-Coeur de Montréal. PARTICIPANTS Ten young, healthy participants with SB (mean age = 26 ± 1.8 years) and 9 without SB (mean age = 29 ± 1.2 years). INTERVENTIONS N/A MEASUREMENTS AND RESULTS: BP increased with all RMMA/SB and arousal episodes (P ≤ 0.05). The average maximum BP surges (systolic/diastolic ± SE mm Hg) were: 25.6 ± 3.3/12.6 ± 2.0 for RMMA/SB + arousal; 30.1 ± 1.7/19.1 ± 1.9 for RMMA/SB + body movement; 26.0 ± 2.8/15.1 ± 2.0 for RMMA/SB + arousal + body movement; 19.4 ± 2.3/8.9 ± 1.2 for arousal alone; and for RMMA/SB clusters: Episode: 1: 26.2 ± 8.7/16.4 ± 5.7; Episode 2: 21.1 ± 7.9/12.6 ± 6.4. CONCLUSION Rhythmic masticatory muscle activity/sleep bruxism (RMMA/SB) is associated with blood pressure fluctuations during sleep. Arousals and body movements often occur with RMMA/SB and can impact the magnitude of this BP surge.
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Affiliation(s)
- Angela Nashed
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
| | - Paola Lanfranchi
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
| | - Pierre Rompré
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
| | - Maria Clotilde Carra
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
| | - Pierre Mayer
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Clinique du Sommeil, Hotel Dieu, Montréal, Quebec, Canada
| | - Roberto Colombo
- Department of Bioengineering, Salvatore Maugeri Foundation, IRCCS, Veruno Italy
| | - Nelly Huynh
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
| | - Gilles Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Clinique du Sommeil, Hotel Dieu, Montréal, Quebec, Canada
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Carra MC, Huynh N, Lavigne G. Sleep bruxism: a comprehensive overview for the dental clinician interested in sleep medicine. Dent Clin North Am 2012; 56:387-413. [PMID: 22480810 DOI: 10.1016/j.cden.2012.01.003] [Citation(s) in RCA: 155] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sleep bruxism (SB) is a common sleep-related motor disorder characterized by tooth grinding and clenching. SB diagnosis is made on history of tooth grinding and confirmed by polysomnographic recording of electromyographic (EMG) episodes in the masseter and temporalis muscles. The typical EMG activity pattern in patients with SB is known as rhythmic masticatory muscle activity (RMMA). The authors observed that most RMMA episodes occur in association with sleep arousal and are preceded by physiologic activation of the central nervous and sympathetic cardiac systems. This article provides a comprehensive review of the cause, pathophysiology, assessment, and management of SB.
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Affiliation(s)
- Maria Clotilde Carra
- Faculty of Dental Medicine, Univeristé de Montréal, CP 6128 Succursale Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.
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