Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy.
Department of Otolaryngology, Ospedale Morgani-Pierantoni, Forlì, Italy.
J Oral Rehabil. 2022 Jan;49(1):47-53. doi: 10.1111/joor.13271. Epub 2021 Nov 15.
Obstructive sleep apnea (OSA) is the most common sleep disorder due mainly to peripheral causes, characterized by repeated episodes of obstruction of the upper airways, associated with arousals and snoring. Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or nonrhythmic (tonic) and is not a movement disorder or a sleep disorder in otherwise healthy individuals. Given the potentially severe consequences and complications of apnea, the concurrent high prevalence of SB in daily dental practice, getting deeper into the correlation between these phenomena is worthy of interest..
The aim of this study was to investigate the correlation between SB-related masseter muscle activity (MMA) and apnea-hypopnea events as well as to assess their temporal sequence.
Thirty (N = 30) patients with sleep respiratory disorders and clinical suspicion of sleep bruxism (SB) were recruited. Ambulatory polygraphic recording was performed to detect apnea-hypopnea events (AHEs) and sleep bruxism episodes (SBEs). Pearson test was used to assess the correlation between apnea-hypopnea index (AHI) and SB index (SBI). A 5-s time window with respect to the respiratory events was considered to describe the temporal distribution of SBEs. Furthermore, SBI was compared between groups of patients with different AHI severity (i.e., mild, moderate and severe) using ANOVA.
On average, AHI was 27.1 ± 21.8 and SBI 9.1 ± 7.5. No correlation was shown between AHI and SBI. Most of SBEs (66.8%) occurred without a temporal relationship with respiratory events. Considering OSA, 65.7% of SBEs occurred within 5 s after AHEs, while in the case of central apnea (CA) 83.8% of SBEs occurred before the respiratory event. The participants with severe apnea (N = 9) show a tendency to have higher bruxism indexes when compared to patients with mild (N = 11) and moderate apnea (N = 10).
Findings suggest that: 1. At the study population level, there is no correlation between AHI and SBI, as well as any temporal relationship between SBEs and respiratory events. 2. Specific patterns of temporal relationship might be identified with future studies focusing on the different types of apnea-hypopnea events and bruxism activities.
阻塞性睡眠呼吸暂停（OSA）是最常见的睡眠障碍，主要由周围原因引起，其特征是上呼吸道反复阻塞，伴有觉醒和打鼾。睡眠磨牙症（SB）是睡眠时咀嚼肌的活动，其特征为节律性（阶段性）或非节律性（紧张性），并且在其他健康个体中不是运动障碍或睡眠障碍。鉴于呼吸暂停的潜在严重后果和并发症，以及在日常牙科实践中 SB 的高发率，深入研究这些现象之间的相关性是值得关注的。
本研究旨在调查睡眠呼吸暂停相关的咬肌肌电活动（MMA）与呼吸暂停低通气事件之间的相关性，并评估它们的时间顺序。
招募了 30 名患有睡眠呼吸障碍并伴有睡眠磨牙症（SB）临床怀疑的患者。进行动态多导睡眠图记录以检测呼吸暂停低通气事件（AHEs）和睡眠磨牙症发作（SBEs）。使用 Pearson 检验评估呼吸暂停低通气指数（AHI）与睡眠磨牙症指数（SBI）之间的相关性。考虑到呼吸事件，使用 5 秒的时间窗口来描述 SBEs 的时间分布。此外，使用方差分析比较不同 AHI 严重程度（轻度、中度和重度）患者的 SBI。
平均而言，AHI 为 27.1±21.8，SBI 为 9.1±7.5。AHI 与 SBI 之间未显示出相关性。大多数 SBEs（66.8%）发生时与呼吸事件没有时间关系。考虑到 OSA，65.7%的 SBEs发生在 AHEs 后 5 秒内，而在中枢性呼吸暂停（CA）的情况下，83.8%的 SBEs发生在呼吸事件之前。与轻度（N=11）和中度（N=10）呼吸暂停的患者相比，严重呼吸暂停（N=9）的患者的磨牙症指数有升高的趋势。
研究结果表明：1. 在研究人群水平上，AHI 与 SBI 之间没有相关性，SBEs 与呼吸事件之间也没有时间关系。2. 通过未来针对不同类型的呼吸暂停低通气事件和磨牙症活动的研究，可以确定特定的时间关系模式。
