Abstract
The present research aimed to investigate the influence of sleep bruxism (SB) intensity on blood pressure parameters in normotensive subjects by using an ambulatory blood pressure device. The study group included 65 normotensive individuals suspected of having SB. All participants underwent one-night video-polysomnography, and ambulatory blood pressure monitoring was performed the next day; 86.15% of them were diagnosed with SB. Statistical analysis included correlation and regression analysis. The obtained results showed that systolic blood pressure variability during sleep significantly increased in individuals with BEI > 4 (bruxism episodes index; episodes/hour) compared to those with BEI ≤ 4 (8.81 ± 3.36 versus 10.57 ± 3.39, p = 0.05). Multivariable regression analysis showed that systolic blood pressure variability at nighttime was also associated with the following independent risk factors: higher apnea-to-bruxism index, male gender, BEI > 4 episodes/hour, body mass index (BMI) ≥ 25 kg/m2, higher arousal index, and shorter total sleep time. In summary, sleep bruxism intensity was associated with increased systolic blood pressure variability during sleep. Coincidental apnea, male gender, severe sleep bruxism (SB intensity with BEI > 4/hour), excess weight and obesity, higher arousal index, and shorter sleep time seem to be the main determinants that influence blood pressure in normotensive sleep bruxers.
Highlights
Nocturnal drop in blood pressure (BP) is a physiological component of circadian rhythm. [1] The dipping of BP at nighttime is an effect of sympathetic tone decrease during sleep
Several theories on sleep bruxism etiology and pathophysiology have been proposed; some of these theories focus on a genetic basis and neurotransmission [8], while others focus on psychological risk factors or sympathetic hyperreactivity
After one-night PSG, 56 (86.15%) participants met the criteria for Sleep bruxism (SB), of which 25 were diagnosed with mild/moderate SB (BEI = 2–4 events/h) and 31 had severe SB (BEI > 4 events/h)
Summary
Nocturnal drop in blood pressure (BP) is a physiological component of circadian rhythm. [1] The dipping of BP at nighttime is an effect of sympathetic tone decrease during sleep. [1] The dipping of BP at nighttime is an effect of sympathetic tone decrease during sleep. Absent or diminished decrease in BP during sleep is associated with increased cardiovascular mortality and morbidity [2,3]. Sleep bruxism (SB) is a common sleep-related disorder. Several theories on sleep bruxism etiology and pathophysiology have been proposed; some of these theories focus on a genetic basis and neurotransmission [8], while others focus on psychological risk factors or sympathetic hyperreactivity. Clinical manifestations of SB include tooth grinding and/or jaw clenching, abnormal tooth wear, and jaw muscle pain due to the fact of jaw muscle activity (rhythmic masticatory muscle activity (RMMA)) during sleep and are classified in the 3rd edition of the International Classification of Sleep Disorders [11]
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