Saito Miku, Yamaguchi Taihiko, Mikami Saki, Watanabe Kazuhiko, Gotouda Akihito, Okada Kazuki, Hishikawa Ryuki, Shibuya Eiji, Shibuya Yoshie, Lavigne Gilles
Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Kita 13 Nishi 7, Kita-ku, Sapporo, 060-8586, Japan.
Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan.
Sleep Breath. 2016 May;20(2):703-9. doi: 10.1007/s11325-015-1284-x. Epub 2015 Nov 12.
No definitive associations or causal relationships have been determined between obstructive sleep apnea-hypopnea (OSAH) and sleep bruxism (SB). The purpose of this study was to investigate, in a population reporting awareness of both OSAH and SB, the associations between each specific breathing and jaw muscle event.
Polysomnography and audio-video data of 59 patients reporting concomitant OSAH and SB history were analyzed. Masseteric bursts after sleep onset were scored and classified into three categories: (1) sleep rhythmic masticatory muscle activity with SB (RMMA/SB), (2) sleep oromotor activity other than RMMA/SB (Sleep-OMA), and (3) wake oromotor activity after sleep onset (Wake-OMA). Spearman's rank correlation coefficient analyses were performed. Dependent variables were the number of RMMA/SB episodes, RMMA/SB bursts, Sleep-OMA, and Wake-OMA; independent variables were apnea-hypopnea index (AHI), arousal index(AI), body mass index(BMI), gender, and age.
Although all subjects had a history of both SB and OSAH, sleep laboratory results confirmed that these conditions were concomitant in only 50.8 % of subjects. Moderate correlations were found in the following combinations (p < 0.05); RMMA/SB episode with AI, RMMA/SB burst with AI and age, Sleep-OMA burst with AHI, and Wake-OMA burst with BMI.
The results suggest that (1) sleep arousals in patients with concomitant SB and OSAH are not strongly associated with onset of RMMA/SB and (2) apnea-hypopnea events appear to be related to higher occurrence of other types of sleep oromotor activity, and not SB activity. SB genesis and OSAH activity during sleep are probably influenced by different mechanisms.
阻塞性睡眠呼吸暂停低通气（OSAH）与睡眠磨牙症（SB）之间尚未确定明确的关联或因果关系。本研究的目的是在报告同时患有OSAH和SB的人群中，调查每种特定呼吸和颌面部肌肉事件之间的关联。
分析了59例报告有OSAH和SB病史的患者的多导睡眠图和视听数据。对睡眠开始后的咬肌爆发进行评分并分为三类：（1）伴有SB的睡眠节律性咀嚼肌活动（RMMA/SB），（2）RMMA/SB以外的睡眠口面部运动活动（睡眠-OMA），以及（3）睡眠开始后的觉醒口面部运动活动（觉醒-OMA）。进行了Spearman等级相关系数分析。因变量为RMMA/SB发作次数、RMMA/SB爆发次数、睡眠-OMA和觉醒-OMA；自变量为呼吸暂停低通气指数（AHI）、觉醒指数（AI）、体重指数（BMI）、性别和年龄。
尽管所有受试者都有SB和OSAH病史，但睡眠实验室结果证实，这些情况仅在50.8%的受试者中同时存在。在以下组合中发现了中度相关性（p < 0.05）；RMMA/SB发作次数与AI、RMMA/SB爆发次数与AI和年龄、睡眠-OMA爆发次数与AHI、觉醒-OMA爆发次数与BMI。
结果表明，（1）同时患有SB和OSAH的患者的睡眠觉醒与RMMA/SB的发作没有强烈关联，（2）呼吸暂停低通气事件似乎与其他类型的睡眠口面部运动活动的较高发生率有关，而与SB活动无关。睡眠期间SB的发生和OSAH的活动可能受不同机制影响。
