Phillips B A, Okeson J, Paesani D, Gilmore R
Chest. 1986 Sep;90(3):424-9. doi: 10.1378/chest.90.3.424.
Parafunctional activity (toothgrinding, toothclenching and bruxism) is a common problem which may lead to masticatory muscle and temporomandibular joint pain, and may result from sleep arousal or disturbances. Sleep apnea is another common sleep disorder which results in disrupted sleep architecture and frequent arousals. Because sleep apnea leads to sleep arousals, and because sleep arousals are thought to result in increased parafunctional activity, we undertook the present study to determine the relationship between sleep apnea and parafunctional activity. We were also interested in assessing the effects of sleep posture on sleep disordered breathing and parafunctional activity. We prospectively studied 24 patients who were referred to the clinical sleep apnea laboratory for study. They underwent standard nocturnal polysomnographic examination; in addition, masticatory activity was measured with a masseter electromyogram. Patients slept in the supine and lateral decubitus positions. Nocturnal clenching was slightly higher in patients with sleep apnea than those without (12.2 vs 7.6 clenches/hr, p = 0.18), and there was a correlation between the clench index (CI) and apnea plus hypopnea index (A + HI) by linear regression (r = 0.49, p less than 0.05). There were significant falls in both the A + HI (64.4 +/- 28.8 vs 36.5 +/- 36.7, p = 0.02) and CI (12.5 +/- 12.1 vs 7.0 +/- 8.6, p = 0.04) in the lateral decubitus vs supine sleeping positions. We conclude that there is an association between obstructive sleep apnea and parafunctional activity, that sleep position affects the incidence of both sleep disordered breathing and parafunctional activity, and that analysis of apneas and hypopneas in both supine and lateral decubitus sleeping positions may be helpful.
副功能活动（磨牙、紧咬牙和磨牙症）是一个常见问题，可能导致咀嚼肌和颞下颌关节疼痛，且可能由睡眠觉醒或干扰引起。睡眠呼吸暂停是另一种常见的睡眠障碍，会导致睡眠结构紊乱和频繁觉醒。由于睡眠呼吸暂停会导致睡眠觉醒，且睡眠觉醒被认为会导致副功能活动增加，我们开展了本研究以确定睡眠呼吸暂停与副功能活动之间的关系。我们还对评估睡眠姿势对睡眠呼吸障碍和副功能活动的影响感兴趣。我们前瞻性地研究了24名被转诊至临床睡眠呼吸暂停实验室进行研究的患者。他们接受了标准的夜间多导睡眠图检查；此外，用咬肌肌电图测量咀嚼活动。患者分别采用仰卧位和侧卧位睡眠。睡眠呼吸暂停患者的夜间紧咬牙情况略高于无睡眠呼吸暂停患者（每小时紧咬牙次数分别为12.2次和7.6次，p = 0.18），通过线性回归分析，紧咬牙指数（CI）与呼吸暂停加低通气指数（A + HI）之间存在相关性（r = 0.49，p < 0.05）。与仰卧位睡眠相比，侧卧位睡眠时A + HI（64.4±28.8 vs 36.5±36.7，p = 0.02）和CI（12.5±12.1 vs 7.0±8.6，p = 0.04）均显著下降。我们得出结论，阻塞性睡眠呼吸暂停与副功能活动之间存在关联，睡眠姿势会影响睡眠呼吸障碍和副功能活动的发生率，并且对仰卧位和侧卧位睡眠时的呼吸暂停和低通气情况进行分析可能会有所帮助。
