Faculty of Dental Medicine, Universite de Montreal & CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada.
Department of Oral Physiology Graduate School of Dentistry, Sleep Medicine Center, Osaka University Hospital, Osaka University, Suita, Japan.
J Sleep Res. 2021 Oct;30(5):e13320. doi: 10.1111/jsr.13320. Epub 2021 Mar 6.
A recent report from the European Sleep Research Society's task force "Beyond AHI" discussed an issue that has been a long-term subject of debate - what are the best metrics for obstructive sleep apnoea (OSA) diagnosis and treatment outcome assessments? In a similar way, sleep bruxism (SB) metrics have also been a recurrent issue for >30 years and there is still uncertainty in dentistry regarding their optimisation and clinical relevance. SB can occur alone or with comorbidities such as OSA, gastroesophageal reflux disorder, insomnia, headache, orofacial pain, periodic limb movement, rapid eye movement behaviour disorder, and sleep epilepsy. Classically, the diagnosis of SB is based on the patient's dental and medical history and clinical manifestations; electromyography is used in research and for complex cases. The emergence of new technologies, such as sensors and artificial intelligence, has opened new opportunities. The main objective of the present review is to stimulate the creation of a collaborative taskforce on SB metrics. Several examples are available in sleep medicine. The development of more homogenised metrics could improve the accuracy and refinement of SB assessment, while moving forward toward a personalised approach. It is time to develop SB metrics that are relevant to clinical outcomes and benefit patients who suffer from one or more possible negative consequences of SB.
最近,欧洲睡眠研究学会的“超越 AHI”工作组发布了一份报告,讨论了一个长期存在争议的问题——阻塞性睡眠呼吸暂停(OSA)的诊断和治疗效果评估的最佳指标是什么?类似地,磨牙症(SB)的指标也已经成为一个反复出现的问题,已有超过 30 年,在牙科领域,关于其优化和临床相关性仍存在不确定性。SB 可单独发生,也可与 OSA、胃食管反流病、失眠、头痛、口面痛、周期性肢体运动、快速眼动行为障碍和睡眠性癫痫等共病同时发生。经典的 SB 诊断基于患者的牙科和病史以及临床表现;肌电图用于研究和复杂病例。新型技术(如传感器和人工智能)的出现带来了新的机会。本综述的主要目的是激发成立一个关于 SB 指标的协作工作组。在睡眠医学中已经有了一些例子。更同质化指标的开发可以提高 SB 评估的准确性和精细度,同时朝着个性化方法推进。现在是时候开发与临床结果相关的 SB 指标,使患有 SB 一种或多种可能负面后果的患者受益了。