Polysomnographic Evaluation of Sleep Bruxism Intensity and Sleep Architecture in Nonapneic Hypertensives: A Prospective, Observational Study

Abstract

Sleep bruxism (SB) is a repetitive jaw muscle activity characterized by clenching or grinding of the teeth, which is classified under sleep-related movement disorders in the International Classification of Sleep Disorders—Third Edition. Because the potential common pathomechanism of SB and arterial hypertension is the activation of the sympathetic system as well as an increase in inflammatory factors, we aimed to examine the intensity of SB and the sleep architecture among patients with arterial hypertension. The study included a total of 91 Caucasian adult patients, among whom 31 had arterial hypertension diagnosed according to the current European Society of Cardiology/European Society of Hypertension (ESC/EHS) hypertension guidelines. The control group consisted of 61 normotensive patients. Patients with obstructive sleep apnea were excluded. A single full-night polysomnographic examination was conducted in the Sleep Laboratory, and then the results were analyzed based on the guidelines of the American Academy of Sleep Medicine. Bruxism episode index (BEI) was higher in the hypertensive group compared to normotensives. The groups also showed statistically significant differences in polysomnographic sleep indexes. Similar to BEI, arousal index, apnea–hypopnea index, and snoring were higher in hypertensives compared to normotensives. On the other hand, the mean and minimal oxygen saturation were lower in hypertensives compared to normotensives. A statistically significant positive correlation was observed between oxygen desaturation index and BEI in the hypertensive group, whereas this correlation was not statistically significant in the case of normotensives. In summary, nonapneic hypertensives had higher SB intensity, altered sleep architecture, decreased mean oxygen saturation, and increased snoring compared to normotensives. The results suggest that dental screening is necessary for patients with arterial hypertension, especially those presenting with the symptoms of SB.

Dental occlusion characteristics in subjects with bruxism

“…One definition considers bruxism as an involuntarily executed parafunctional behavior in which the jaw muscles force the teeth against one other horizontally [ 2 ]. The International Classification of Sleep Disorders-Third Edition classifies sleep bruxism (SB) as a repetitive jaw muscular activity characterized by clenching or grinding of the teeth [ 3 ].…”

Systematic Review on the Link between Sleep Bruxism and Systemic Chronic Inflammation

“…It has been proven to not only be a consequence but also a critical contributor to the course of these diseases [51]. Recent studies suggest that dental screening is necessary for patients with one of the most prevalent CVD diseases, namely arterial hypertension [28]. This particularly concerns patients presenting with symptoms of SB.…”

“…However, this value varies depending on the age group. SB is successfully established to escalate the risk of endothelial remodeling [27] and hypertension [28]. The necessity of finding common features in the patomechanism between SCI and SB is emphasized by the increase in cardiovascular risk accompanied by SCI [29].…”