Abstract
Sleep bruxism is a common sleep-related behavior characterized as repetitive masticatory muscle activity. Genetic vulnerability to stress and anxiety is considered a basal component in the pathogenesis of bruxism events. Dysfunction of the autonomic nervous system related with an arousal during sleep is considered an underlying cause of the cardiovascular implications of sleep bruxism. Increased cardiovascular risk was previously linked with sleep conditions: for example, obstructive sleep apnea and insomnia, and sleep bruxism. The aim of present systematic review was to evaluate the current arguments on the relationship between sleep bruxism and cardiovascular diseases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We have reviewed the Embase, PubMed (Medline) and Scopus databases to identify applicable articles (1994–2021). A total of 127 records in English language were identified, then after screening and exclusion of nonrelevant records, 19 full-text articles were evaluated. Finally, we included 12 studies for synthesis. Due to the heterogeneity of the compared studies, only a qualitative comparison and narrative summary were performed. In the majority of studies, increased sympathetic activity was successfully established to escalate heart rate variability, the inflammatory process, oxidative stress, endothelial remodeling and hormonal disturbances, leading to hypertension and other cardiovascular complications.
Highlights
One of the major topics investigated in the field of sleep conditions is sleep bruxism (SB)
This review investigates a relatively new area which has emerged from the pathophysiology of sleep bruxism, establishing that increased sympathetic activity is a core of the causal chain with an initial increase in heart rate and microarousal accompanied by rhythmic masticatory muscle activity (RMMA)
Some studies focused on blood pressure in the context of sleep bruxism [29,30,32,35]; others evaluated changes in heart rate [24,26,28,33] in sleep bruxers
Summary
One of the major topics investigated in the field of sleep conditions is sleep bruxism (SB). Clinical symptoms of SB are classified in the 3rd edition of International Classification of Sleep Disorders and involve regular or frequent bruxism events during sleep and the presence of abnormal tooth wear or incidents of jaw muscle pain or fatigue [2]. The prevalence of sleep bruxism in the adult population is estimated to be about 8% [7,8] up to 13% [9]; it varies depending on age group. Accepted and used diagnostic criteria for sleep bruxism were proposed by the American Academy of Sleep Medicine (AASM) [10] and international consensus by Lobbezoo et al [11], but polysomnography remains the gold standard [12]
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