Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan.
Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
J Clin Sleep Med. 2023 Feb 1;19(2):379-392. doi: 10.5664/jcsm.10344.
This study investigated the diagnostic accuracy of Sleep Profiler, which relies on ambulatory polysomnography (PSG) with electroencephalogram for sleep bruxism (SB) and examined its episode-by-episode agreement in comparison to PSG equipped with audiovisual recordings (avPSG).
This prospective 2-gate study recruited 10 individuals with probable SB and 10 healthy volunteers. Overnight experimental recordings were performed simultaneously using the ambulatory PSG with masseter electromyography and avPSG with masseter and temporalis electromyography. Sleep staging was performed manually for avPSG and automatically or manually for ambulatory PSG. SB episodes were manually scored based on electromyography signals with reference to sleep stages. The episode-by-episode agreement was analyzed by setting avPSG as the reference standard. The sensitivity, specificity, and accuracy for the diagnosis of SB were calculated after optimizing the cutoff values of the episode index and the burst index.
Regarding the episode-by-episode agreement, median sensitivities were 0.825 and positive predictive values were approximately 0.6, regardless of the sleep staging procedure, indicating that approximately 40% of the overall total SB episodes scored by the ambulatory PSG were false positives. Because of overestimation of SB episodes, the optimal cutoff values for the episode index and the burst index were approximately 1.5 times higher than the avPSG-based cutoff values and dramatically improved the diagnostic precision metrics for the ambulatory PSG.
Sleep Profiler can eliminate events during wakefulness by electroencephalogram and may provide a definitive diagnosis in patients with possible SB by applying optimized cutoff values. However, the risk of overestimation must be recognized.
Registry: UMIN Clinical Trials Registry; Name: Accuracy of Portable PSG Device for Detection of Sleep Bruxism-Related Masseter EMG Muscle Activity; URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037380; Identifier: UMIN000032793.
Abe Y, Nakazato Y, Takaba M, Kawana F, Baba K, Kato T. Diagnostic accuracy of ambulatory polysomnography with electroencephalogram for detection of sleep bruxism-related masticatory muscle activity. 2023;19(2):379-392.
本研究旨在调查睡眠分析器的诊断准确性，该分析器依赖于脑电图的动态多导睡眠描记术（PSG）来诊断睡眠磨牙症（SB），并通过与配备视听记录的 PSG（avPSG）进行逐 episode 比较来检查其逐 episode 一致性。
本前瞻性双门研究招募了 10 名可能患有 SB 的个体和 10 名健康志愿者。使用动态 PSG 结合咀嚼肌肌电图和配备咀嚼肌和颞肌肌电图的 avPSG 同时进行夜间实验记录。avPSG 进行手动睡眠分期，自动或手动进行动态 PSG 睡眠分期。根据肌电图信号参考睡眠阶段对 SB 发作进行手动评分。以 avPSG 为参考标准分析逐 episode 一致性。优化 episode 指数和爆发指数的截断值后，计算 SB 诊断的灵敏度、特异性和准确性。
无论睡眠分期程序如何，逐 episode 一致性的中位灵敏度均为 0.825，阳性预测值约为 0.6，这表明动态 PSG 评分的总 SB 发作中约有 40%为假阳性。由于 SB 发作的高估，episode 指数和爆发指数的最佳截断值约为基于 avPSG 的截断值的 1.5 倍，这极大地提高了动态 PSG 的诊断精度指标。
睡眠分析器可以通过脑电图消除清醒时的事件，并通过应用优化的截断值为可能患有 SB 的患者提供明确的诊断。然而，必须认识到高估的风险。
注册号：UMIN 临床试验注册；名称：便携式 PSG 设备检测睡眠磨牙症相关咀嚼肌肌电图活动的准确性；网址：https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037380；标识符：UMIN000032793。
Abe Y, Nakazato Y, Takaba M, Kawana F, Baba K, Kato T. 便携式 PSG 设备检测睡眠磨牙症相关咀嚼肌肌电图活动的准确性。 2023;19(2):379-392.
