Muzalev Konstantin, Lobbezoo Frank, Janal Malvin N, Raphael Karen G
Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, New York University College of Dentistry, New York, NY.
Sleep. 2017 Aug 1;40(8). doi: 10.1093/sleep/zsx078.
Sleep bruxism (SB) is considered as a possible etiological factor for temporomandibular disorder (TMD) pain. However, polysomnographic (PSG) studies, which are current "gold standard" diagnostic approach to SB, failed to prove an association between SB and TMD. A possible explanation could be that PSG studies have considered only limited characteristics of SB activity: the number of SB events per hour and, sometimes, the total duration of SB per night. According to the sports sciences literature, lack of adequate rest time between muscle activities leads to muscle overloading and pain. Therefore, the aim of this study was to determine whether the intervals between bruxism events differ between patients with and without TMD pain.
Two groups of female volunteers were recruited: myofascial TMD pain group (n=124) and non-TMD control group (n=46). From these groups, we selected 86 (69%) case participants and 37 (80%) controls who had at least two SB episodes per night based on PSG recordings. A linear mixed model was used to compare case and control groups over the repeated observations of interepisode intervals.
The duration of interepisode intervals was statistically similar in the case (mean [standard deviation {SD}] 1137.7 [1975.8] seconds)] and control (mean [SD] 1192.0 [1972.0] seconds) groups. There were also a similar number of SB episodes per hour and a total duration of SB episodes in both groups.
The current data fail to support the idea that TMD pain can be explained by increasing number of SB episodes per hour of sleep or decreasing the time between SB events.
睡眠磨牙症（SB）被认为是颞下颌关节紊乱病（TMD）疼痛的一个可能病因。然而，多导睡眠图（PSG）研究作为目前诊断SB的“金标准”方法，未能证实SB与TMD之间存在关联。一个可能的解释是，PSG研究仅考虑了SB活动的有限特征：每小时的SB事件数量，有时还包括每晚SB的总时长。根据运动科学文献，肌肉活动之间缺乏足够的休息时间会导致肌肉过载和疼痛。因此，本研究的目的是确定有TMD疼痛和无TMD疼痛的患者之间磨牙症事件的间隔是否存在差异。
招募了两组女性志愿者：肌筋膜TMD疼痛组（n = 124）和非TMD对照组（n = 46）。从这些组中，我们根据PSG记录选择了每晚至少有两次SB发作的86名（69%）病例参与者和37名（80%）对照者。使用线性混合模型在发作间隔的重复观察中比较病例组和对照组。
病例组（平均[标准差{SD}]1137.7[1975.8]秒）和对照组（平均[SD]1192.0[1972.0]秒）的发作间隔持续时间在统计学上相似。两组每小时的SB发作次数以及SB发作的总时长也相似。
目前的数据不支持TMD疼痛可通过每小时睡眠中SB发作次数增加或SB事件之间时间缩短来解释这一观点。
