Associated factors of primary snoring and obstructive sleep apnoea in patients with sleep bruxism: A questionnaire study

Abstract

Background: By being aware of the associated factors of primary snoring (PS) and obstructive sleep apnoea (OSA) in sleep bruxism (SB) patients, dentists may contribute to the screening and early recognition of SB patients with PS or OSA.Objective: To identify the associated factors of PS and OSA from questionnaire-based data in SB patients.Methods: A total of 968 self-reported SB patients (31.6% men; median age 44.5 years) were retrospectively enrolled. Self-reported sleep-related breathing status (viz., no sleep-related breathing condition, PS and OSA) was the dependent variable. Independent variables were questionnaire-based data on demographics, lifestyle, psychological status, pain and sleep. Results:For PS, no statistically significant associated factor was identified in analyses.For OSA, increased age (OR = 1.04 [1.03-1.06]), male gender (OR = 3.33 [2.17-5.00]), daily alcohol consumption (OR = 1.96 [1.18-3.33]), depression (OR = 1.10 [1.06-1.14]), daytime sleepiness (OR = 2. 94 [1.85-4.76]) and high risk of gastroesophageal reflux disease (GERD; OR = 2.63 [1.52-4.76]) were found to be significant risk factors, while high risk of temporomandibular disorder (TMD) pain (OR = 0.51 [0.30-0.86]) and chronic pain (OR = 0.73 [0.59-0.90]) were significant protective factors. These results were confirmed in the subsequent network analysis. Conclusion:Within the limitations of this study, no associated factor is identified for PS. For OSA, dentists should keep in mind that increased age, male gender, daily alcohol consumption, depression, daytime sleepiness and high GERD risk are associated with increased OSA risk in SB patients, while high TMD-pain risk and chronic pain are associated with decreased OSA risk in this population.

Secondary bruxism: A valid diagnosis or just a coincidental finding of additional masticatory muscle activity? A narrative review of literature

“…Its prevalence is not well documented but patients without OSA seems to have more snoring events than OSA‐free patients 47 . Prevalence of PS in SB ranges from 7.3% 30 to 32.7% 48 . A plausible temporality between PS and BS is still to be demonstrated.…”

“…Sleep breathing events, especially mild to moderate obstructive sleep apnoea (OSA), primary snoring (PS) and clinical conditions of upper airway obstruction such as asthma, sinusitis, rhinitis and oedema, due to hypertrophy of tonsils and adenoids have been described in literature. [28][29][30][31][32][33] The prevalence of OSA in the general population is about 22% in men and 17% in women. 34 This prevalence is age-dependent, increasing from 38% at 50 years old to up to 84% above 70 years.…”

“…Among those factors, respiratory disorders during sleep are of great concern. Sleep breathing events, especially mild to moderate obstructive sleep apnoea (OSA), primary snoring (PS) and clinical conditions of upper airway obstruction such as asthma, sinusitis, rhinitis and oedema, due to hypertrophy of tonsils and adenoids have been described in literature 28–33 …”

The effect of sleep position on sleep bruxism in adults with obstructive sleep apnea

“…Besides sleep arousal, many other factors, including sex, body mass index (BMI), and sleep staging have been reported to be associated with OSA, SB, or both. 5,[14][15][16] Further, in 56% of adults with OSA, respiratory events occur mainly in their supine position. 8 Therefore, we hypothesized that the RMMA index in supine position (RMMA_sup index) is significantly higher than RMMA index in non-supine positions (RMMA_nsup index) in adults with OSA.…”

Neuromuscular and occlusion analysis to evaluate the efficacy of three splints on patients with bruxism

“…Bruxism was originally thought to be a central nervous system problem, associated with anxiety, tension, and the release of stressful [4]. Recent studies have shown that bruxism may be caused by a synergistic effect of multiple factors, such as genetic factors [5], neuropsychological factors (long-term anxiety and tension) [6,7], physiological and pathological factors (malocclusion, snoring, sleep disorder) [8][9][10][11], and bad lifestyle habits (smoking, alcoholism, excessive caffeine intake) [12][13][14][15].…”