Kanclerska Justyna, Wieckiewicz Mieszko, Poreba Rafal, Szymanska-Chabowska Anna, Gac Pawel, Wojakowska Anna, Frosztega Weronika, Michalek-Zrabkowska Monika, Mazur Grzegorz, Martynowicz Helena
Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland.
Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland.
J Clin Med. 2022 May 31;11(11):3113. doi: 10.3390/jcm11113113.
Sleep bruxism (SB) is a repetitive jaw muscle activity characterized by clenching or grinding of the teeth, which is classified under sleep-related movement disorders in the International Classification of Sleep Disorders-Third Edition. Because the potential common pathomechanism of SB and arterial hypertension is the activation of the sympathetic system as well as an increase in inflammatory factors, we aimed to examine the intensity of SB and the sleep architecture among patients with arterial hypertension. The study included a total of 91 Caucasian adult patients, among whom 31 had arterial hypertension diagnosed according to the current European Society of Cardiology/European Society of Hypertension (ESC/EHS) hypertension guidelines. The control group consisted of 61 normotensive patients. Patients with obstructive sleep apnea were excluded. A single full-night polysomnographic examination was conducted in the Sleep Laboratory, and then the results were analyzed based on the guidelines of the American Academy of Sleep Medicine. Bruxism episode index (BEI) was higher in the hypertensive group compared to normotensives. The groups also showed statistically significant differences in polysomnographic sleep indexes. Similar to BEI, arousal index, apnea-hypopnea index, and snoring were higher in hypertensives compared to normotensives. On the other hand, the mean and minimal oxygen saturation were lower in hypertensives compared to normotensives. A statistically significant positive correlation was observed between oxygen desaturation index and BEI in the hypertensive group, whereas this correlation was not statistically significant in the case of normotensives. In summary, nonapneic hypertensives had higher SB intensity, altered sleep architecture, decreased mean oxygen saturation, and increased snoring compared to normotensives. The results suggest that dental screening is necessary for patients with arterial hypertension, especially those presenting with the symptoms of SB.
睡眠磨牙症(SB)是一种以牙齿紧咬或磨动为特征的重复性颌面部肌肉活动,在《国际睡眠障碍分类第三版》中被归类为与睡眠相关的运动障碍。由于SB与动脉高血压潜在的共同病理机制是交感神经系统的激活以及炎症因子的增加,我们旨在研究动脉高血压患者的SB强度和睡眠结构。该研究共纳入91名成年白种人患者,其中31例根据当前欧洲心脏病学会/欧洲高血压学会(ESC/EHS)高血压指南被诊断为动脉高血压。对照组由61名血压正常的患者组成。排除阻塞性睡眠呼吸暂停患者。在睡眠实验室进行了一次整夜的多导睡眠图检查,然后根据美国睡眠医学会的指南对结果进行分析。高血压组的磨牙症发作指数(BEI)高于血压正常组。两组在多导睡眠图睡眠指标上也显示出统计学上的显著差异。与BEI相似,高血压组的觉醒指数、呼吸暂停低通气指数和打鼾情况均高于血压正常组。另一方面,高血压组的平均和最低血氧饱和度低于血压正常组。在高血压组中,观察到氧饱和度下降指数与BEI之间存在统计学上的显著正相关,而在血压正常组中这种相关性无统计学意义。总之,与血压正常者相比,非呼吸暂停性高血压患者的SB强度更高、睡眠结构改变、平均血氧饱和度降低且打鼾增加。结果表明,对于动脉高血压患者,尤其是那些有SB症状的患者,进行牙科筛查是必要的。