Sleep bruxism associated with obstructive sleep apnoea syndrome – A pilot study using a new portable device

Abstract

Sleep bruxism (SB) and obstructive sleep apnoea syndrome (OSAS) share common pathophysiologic pathways. We aimed to study the presence and relationship of SB in a OSAS population. Patients referred with OSAS suspicion and concomitant SB complains were evaluated using a specific questionnaire, orofacial evaluation and cardio-respiratory polygraphy that could also monitor audio and EMG of the masseter muscles. From 11 patients studied 9 had OSAS. 55.6% were male, mean age was 46.3±11.3 years, and apnea hypopnea index of 11.1±5.7/h. Through specific questionnaire 55.6% had SB criteria. Orofacial examination (only feasible in 3) confirmed tooth wear in all. 77.8% had polygraphic SB criteria (SB index>2/h). Mean SB index was 5.12±3.6/h, phasic events predominated (72.7%). Concerning tooth grinding episodes, we found a mean of 10.7±9.2 per night. All OSAS patients except two (77.8%) had more than two audible tooth-grinding episodes. These two patients were the ones with the lowest SB index (1.0 and 1.4 per hour). Only in one patient could we not detect tooth grinding episodes. There was a statistically significant positive correlation between tooth grinding episodes and SB index and phasic event index (R=0.755, p=0.019 and R=0.737, p=0.023 respectively, Pearson correlation). Mean apnoea to bruxism index was 0.4/h, meaning that only a minority of SB events were not secondary to OSAS. We could not find any significant correlation between AHI and bruxism index or phasic bruxism index (R=-0.632 and R=-0.611, p>0.05, Pearson correlation). This pilot study shows that SB is a very common phenomenon in a group of mild OSAS patients, probably being secondary to it in the majority of cases. The new portable device used may add diagnostic accuracy and help to tailor therapy in this setting.

The Bruxoff Device as a Screening Method for Sleep Bruxism in Dental Practice

“…Therefore, it could be said that the morning muscle pain and fatigue reported by all patients within the study group were caused by clenching-type (tonic) sleep bruxism [66]. However, other heavily supported research [67,68,69,70,71] showed an increased number of phasic contractions in patients with sleep bruxism, which was not found in this study. This could suggest that the reliability of the Bruxoff device in this particular spectrum needs further study.…”

“…However, even with the research results positioning portable EMG devices among the most reliable and easy to use methods for diagnosing bruxism, the complexity, sensitivity, and irreplaceable value of audio-video recordings in PSG still places it as the most detailed and valid diagnostic method for sleep bruxism. Furthermore, there have been developments in the form of portable sleep monitoring devices, e.g., the Nox-T3 Portable Sleep Monitor (Nox Medical, Reykjavik, Iceland), which seem to answer the need for simplified, yet detailed, diagnostic equipment in terms of sleep bruxism and sleep medicine in general [6,70].…”

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

“…The reasons for excluding studies after full‐text assessment were as follows: review ( n = 4); case report ( n = 1); no PSG is used to diagnose OSAS ( n = 1); survey ( n = 1); different target condition ( n = 2); no determination of the association between OSAS and SB ( n = 2); less than 10 patients ( n = 1); and no PSG is used to confirm SB diagnosis ( n = 1).…”

“…In addition, a recent pilot study reported that SB is a common phenomenon in a group of mild OSAS patients probably being secondary to it in the majority of cases. Only a minority of SB events were not secondary to OSAS.…”

Evaluation of Intensity of Sleep Bruxism in Arterial Hypertension

“…Data were collected using home portable cardiorespiratory polygraphy (Nox-T3 Portable Sleep Monitor, Nox Medical, Reykjavík, Iceland). This device, used to confirm SB and OSA diagnosis, has been previously described [ 28 ]. Nox T3 is a Level 3 portable monitor, which registers the bilateral masseter electromyography (EMG) and the audio evaluation (the sounds of bruxism and snoring were recorded with a microphone integrated within the device).…”