Zhong Zhijun, Li Qi, Zou Xueliang, Ouyang Qian, Zhang Ling, Liu Xinting, Luo Yaxing, Yao Dongyuan
Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China.
Jiangxi Mental Hospital, Nanchang University, Nanchang, People's Republic of China.
J Sleep Res. 2025 Feb;34(1):e14250. doi: 10.1111/jsr.14250. Epub 2024 May 27.
Intracranial pressure is one of the determinants of sympathetic activities, and sleep bruxism is associated with increased sympathetic activities. This study aimed to investigate effects of the low Fowler's sleep position and methazolamide treatment on the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes in patients with sleep bruxism in a randomized controlled trial. Polysomnographic recordings were performed on the patients with sleep bruxism sleeping in the low Fowler's (15°-30°) or supine position (n = 11), and with methazolamide or placebo treatment (100 mg, 3-4 hr before bedtime, P.O., n = 9), and changes in sleep variables and heart rate variance during sleep in the low Fowler's position or with methazolamide treatment were determined. Sleep bruxism index, number of masseter muscle electromyographic bursts per hour of sleep, ratio of rhythmic masticatory muscle activities/sleep bruxism duration to the total sleep duration, index of total limb movements, index of limb movements with rhythmic masticatory muscle activities, and number of sleep bruxism clusters per hour of sleep in the low Fowler's position and after methazolamide intake were significantly smaller (p < 0.05-0.001) than those in the supine position and after placebo intake, respectively. The low-frequency heart rate variance powers during non-rapid eye movement sleep stage 2 (N2) in the low Fowler's position and with methazolamide treatment were significantly lower (p < 0.05) than those during sleep in the supine position and with placebo treatment, respectively. In conclusion, sleep in the low Fowler's position and methazolamide treatment were associated with significant decreases in the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes, which might be due to a reduction in intracranial pressure and sympathetic activities mainly during non-rapid eye movement sleep stage 2.
颅内压是交感神经活动的决定因素之一，而睡眠磨牙症与交感神经活动增加有关。本研究旨在通过一项随机对照试验，探讨低福勒卧位和醋甲唑胺治疗对睡眠磨牙症患者节律性咀嚼肌活动/睡眠磨牙症发作的影响。对睡眠磨牙症患者进行多导睡眠图记录，这些患者分别采用低福勒卧位（15°-30°）或仰卧位睡眠（n = 11），以及采用醋甲唑胺或安慰剂治疗（睡前3-4小时口服100mg，n = 9），并测定低福勒卧位或醋甲唑胺治疗期间睡眠变量和心率变异性的变化。低福勒卧位和服用醋甲唑胺后，睡眠磨牙症指数、每小时睡眠中咬肌肌电爆发次数、节律性咀嚼肌活动/睡眠磨牙症持续时间与总睡眠时间的比值、总肢体运动指数、伴有节律性咀嚼肌活动的肢体运动指数以及每小时睡眠中睡眠磨牙症簇的数量，分别显著低于仰卧位和服用安慰剂后（p < 0.05-0.001）。低福勒卧位和醋甲唑胺治疗期间，非快速眼动睡眠第2阶段（N2）的低频心率变异性功率分别显著低于仰卧位睡眠和安慰剂治疗期间（p < 0.05）。总之，低福勒卧位睡眠和醋甲唑胺治疗与节律性咀嚼肌活动/睡眠磨牙症发作的显著减少有关，这可能是由于主要在非快速眼动睡眠第2阶段颅内压和交感神经活动的降低。
