0667 Sleep Bruxism Associated With Restless Limbs Syndrome (RLS): A Dopamine Responsive Parasomnia.

Abstract

Sleep Bruxism (SB) is a common parasomnia and movement disorder, of unknown etiology, affecting approximately 10% of the population. SB is known to cause insomnia, TMJ and dental and periodontal morbidity. Treatment with Occlusal devices does not stop SB or reduce all dental complications. No pharmacological treatments are currently available. Others have suggested an association of RLS and SB in population studies. Both SB and Periodic Limb Movements of Sleep (PLMS), seen in 80% of patients with RLS, occur in light, non-REM sleep. To our knowledge, there has not been a study of RLS patients to determine if SB is associated and, if so, if it responds to therapies for RLS. Patients meeting the IRLSSG criteria for RLS completed a 35 question survey investigating demographics, symptoms, comorbidities, family history and response to therapy. Charts were reviewed and interviews conducted to complete and clarify the data. The SB patients presented here are a subgroup of an ongoing study of RLS and associated conditions. 676 patients completed the survey at the time of this analysis. 241 (35.7%) had SB. 105 of 241 (43.6%) noted improvement of SB with dopamine agonists (DA). Excluding incomplete respondents (ie: patients who did not receive treatment or could not recall the response) 105 of 139 (75.5%) with RLS and SB had improvement of SB with DA therapy. These data support a strong association between RLS and SB, both movement disorders and parasomnias, and suggest that SB, in this population, may respond to treatment with DA. Although retrospective, non-controlled and unblinded, this study should encourage a blinded and placebo controlled trial of DA for SB associated with RLS. Finally, the data suggests that SB may be a manifestation of RLS and, as such, is a dopamine-responsive parasomnia with possible pharmacotherapy in the future. No support