Relationship between obstructive sleep apnoea syndrome and sleep bruxism: a systematic review

Abstract

Obstructive sleep apnoea syndrome (OSAS) is a clinical risk factor for sleep bruxism (SB). Both OSAS and SB are reported to be associated with sleep-related arousal reactions, although no clear causative link has been established. An electronic literature search was conducted of the MEDLINE, ScienceDirect, Wiley Online Library, SAGE Journals and EBSCOhost databases covering the period January 2006 and September 2016. Sequential screenings at the title, abstract and full-text levels were performed. The review included observational studies in the English language with a clearly established aim to assess the relationship between OSAS and SB using full-night PSG. The seven-item quality-assessment tool for experimental bruxism studies was used to assess the methodology across the studies. After a comprehensive screening of titles, abstracts and full texts, only three studies that met the pre-defined criteria were finally included in this systematic review. Two studies gave evidence that OSAS is associated with the occurrence of SB events: (i) SB events frequently occur during micro-arousal events consequent on apnoea-hypopnoea (AH) events and (ii) most SB events occur in temporal conjunction with AH events termination. However, one study did not report a strong association between AH and SB events. It can be concluded that there are not enough scientific data to define a clear causative link between OSAS and SB. However, they appear to share common clinical features. Further studies should focus on the intermediate mechanisms between respiratory and SB events.

Sleep bruxism and oral health‐related quality of life in children: A systematic review

“…Also, it has been suggested that SB may have positive consequences for some bruxers, since it may have a protective nature, increasing the air patency of the upper respiratory airways and stimulating salivation preventing dental erosion . Moreover, it is the ending episode of a respiratory arousal …”

Bruxism: An umbrella review of systematic reviews

“…Overall, three SR investigated prevalence rates among different populations, seventeen investigated associated factors, six evaluated effects on stomatognathic structures, two evaluated diagnostic accuracy of bruxism assessment tools, and thirteen assessed interventions' effectiveness . Statistical pooling of data using MA was available in 7 studies .…”

“…Overall, nine SR were judged with low risk, seventeen with moderate risk and fifteen with high risk of bias . Major concerns regarding risk of bias were observed, which included the following: (a) lack of a priori registration of the study protocol; (b) inappropriate range of database/electronic sources searched; (c) no risk of bias assessment; (d) study selection, data collection or bias assessment performed by only one reviewer; (e) no publication bias assessment or sensitivity analysis; (f) high risk of bias in included primary studies.…”

“…Regarding sleep breathing disorders in adult populations, De Luca Canto et al suggested that available evidence was insufficient to credit or discredit an association with SB. Similarly, a more recent SR (2018) concluded that there are not enough scientific data to define a clear causative link between obstructive sleep apnoea (OSA) and SB, although some clinical features appear to be common in both conditions.…”

Obstructive sleep apnea syndrome and sleep disorders in individuals with occupational injuries

“…Restless legs syndrome has been shown to disrupt sleep length, sleep quality, and daytime alertness and to impair quality of life and work productivity (Stevens 2015). A recent systematic review reported an association of sleep bruxism with sleep-related arousal, but a clear causative link with OSAS is still questionable (Jokubauskas and Baltrusaityte 2017). Until now, there has been no published evidence showing that individuals with restless legs syndrome or sleep bruxism are at higher risk of injuries.…”