背景:阻塞性睡眠呼吸暂停(OSA)患者的睡眠磨牙症的病因尚未完全阐明。这项前瞻性临床研究旨在调查可能的睡眠磨牙症之间的联系,肌电图肌张力,和多导睡眠监测期间记录的呼吸睡眠模式。
方法:106例OSA患者(74例男性,31名女性,平均年龄:56.1±11.4岁)分为两组(睡眠磨牙症:SB;无睡眠磨牙症:NSB)。可能的SB基于AASM标准:握紧/研磨的自我报告,醒来时的口面部症状,牙齿磨损异常和咬肌肥大。两组均接受了临床检查,是否有疼痛性肌肉症状,符合颞下颌疾病诊断标准(DC/TMD)。如肌痛,肌筋膜疼痛,和头痛归因于颞下颌关节紊乱病。此外,评估非主诉阳性肌肉触诊和口面相关局限性(颌骨功能受限量表-20:JFLS-20).进行了为期一夜的多导睡眠图和肌电图咬肌张力(EMG)测量。描述性数据,计算了组间比较和多变量逻辑回归.
结果:OSA患者的SB患病率为37.1%。睡眠磨牙症组的EMG肌张力(N1-N3,REM;P=0.001)和呼吸不足数(P=0.042)明显高于睡眠磨牙症组。虽然像呼吸暂停低通气指数(AHI)这样的措施,呼吸紊乱指数(RDI),呼吸暂停指数(AI),低通气指数(HI),数量的觉醒,睡眠磨牙者的心率(1/min)升高,差异无统计学意义。睡眠效率无差异(SE;P=0.403)。SB患者的非投诉咬肌触诊(61.5%;P=0.015)和肌痛(41%;P=0.010)显着升高。多因素logistic回归显示EMG肌张力和JFLS-20对磨牙症风险的显着贡献。
结论:OSA患者肌电图肌张力增加和口面局限性可以预测睡眠磨牙症。此外,SB患者更多患有睡眠呼吸障碍。因此,睡眠磨牙症似乎不仅是阻塞性呼吸暂停的口腔健康相关问题。因此,跨学科干预对于有效治疗这些患者至关重要。
背景:该研究已获得飞利浦-马尔堡大学伦理委员会的批准(reg。不。2022年13月22日),并在“德国临床试验登记册”上注册,DRKS“(DRKS0002959)。
BACKGROUND: The etiology of sleep bruxism in obstructive sleep apnea (OSA) patients is not yet fully clarified. This prospective clinical study aimed to investigate the connection between probable sleep bruxism, electromyographic muscle tone, and respiratory sleep patterns recorded during polysomnography.
METHODS: 106 patients with OSA (74 males, 31 females, mean age: 56.1 ± 11.4 years) were divided into two groups (sleep bruxism: SB; no sleep bruxism: NSB). Probable SB were based on the AASM criteria: self-report of clenching/grinding, orofacial symptoms upon awakening, abnormal tooth wear and hypertrophy of the masseter muscle. Both groups underwent clinical examination for painful muscle symptoms aligned with Temporomandibular Disorders Diagnostic Criteria (DC/TMD), such as myalgia, myofascial pain, and headache attributed to temporomandibular disorder. Additionally, non-complaint positive muscle palpation and orofacial-related limitations (Jaw Functional Limited Scale-20: JFLS-20) were assessed. A one-night polysomnography with electromyographic masseter muscle tone (EMG) measurement was performed. Descriptive data, inter-group comparisons and multivariate logistic regression were calculated.
RESULTS: OSA patients had a 37.1% prevalence of SB. EMG muscle tone (N1-N3, REM; P = 0.001) and the number of hypopneas (P = 0.042) were significantly higher in the sleep bruxism group. While measures like apnea-hypopnea-index (AHI), respiratory-disturbance-index (RDI), apnea index (AI), hypopnea-index (HI), number of arousals, and heart rate (1/min) were elevated in sleep bruxers, the differences were not statistically significant. There was no difference in sleep efficiency (SE; P = 0.403). Non-complaint masseter muscle palpation (61.5%; P = 0.015) and myalgia (41%; P = 0.010) were significant higher in SB patients. Multivariate logistic regression showed a significant contribution of EMG muscle tone and JFLS-20 to bruxism risk.
CONCLUSIONS: Increased EMG muscle tone and orofacial limitations can predict sleep bruxism in OSA patients. Besides, SB patients suffer more from sleep disorder breathing. Thus, sleep bruxism seems to be not only an oral health related problem in obstructive apnea. Consequently, interdisciplinary interventions are crucial for effectively treating these patients.
BACKGROUND: The study was approved by the Ethics Committee of Philipps-University Marburg (reg. no. 13/22-2022) and registered at the \"German Clinical Trial Register, DRKS\" (DRKS0002959).