Sleep Bruxism Episodes in Patients with Obstructive Sleep Apnea Syndrome Determined by In-Laboratory Polysomnography

Dong Hyun Kim,Sang Haak Lee,Sang Hwa Lee

doi:10.3390/app10238587

Dong Hyun Kim, Sang Haak Lee + Show 1 more

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https://doi.org/10.3390/app10238587

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Abstract

Findings on sleep bruxism (SB) in patients with obstructive sleep apnea syndrome (OSAS) are controversial, and some of these findings have relied on in-laboratory polysomnography (PSG). We aimed to identify the factors associated with SB episodes in 100 patients with OSAS using in-laboratory PSG records. Subjects with OSAS were divided into those with and without SB episodes. We analyzed the differences in patient characteristics and PSG indices. Age, gender, height, weight, body mass index, neck, waist, and hip circumferences, and the rates of hypertension and diabetes mellitus were not significantly different between the two groups. A greater proportion of stage N2 sleep in the total sleep time, longer total sleep time, longer sleep time in a supine position, shorter sleep time in a nonsupine position, lower apnea–hypopnea index (AHI), lower AHI regardless of sleeping position, lower AHI during nonrapid eye movement sleep, and higher mean oxygen saturation level were associated with SB episodes in patients with OSAS. Among these factors, longer sleep time in a supine position remained a statistically significant factor in multivariate analysis. We conclude that longer sleep time in a supine position (especially >280 min) might be associated with SB episodes in patients with OSAS.

Highlights

Obstructive sleep apnea syndrome (OSAS) is a prevalent sleep disorder characterized by repeated upper airway collapse
Of 84 patients without self-reported sleep bruxism (SB), seven had SB episodes (8.3%; 95% CI, 1.5–7.9%) identified by in-laboratory PSG
We found that sleep stage, sleep position, apnea–hypopnea index (AHI), and oxygen saturation might be more strongly associated with SB episodes than the patients’ characteristics, and that longer sleep time in the supine position might be more significantly associated with SB episodes in patients with obstructive sleep apnea syndrome (OSAS)

Summary

Introduction

Obstructive sleep apnea syndrome (OSAS) is a prevalent sleep disorder characterized by repeated upper airway collapse. It can cause various problems, including daytime sleepiness, neurocognitive disorders, cardiovascular and metabolic disorders, and even traffic accidents [1,2]. SB is sometimes seen in patients with OSAS. Continuous positive airway pressure (CPAP) therapy is highly effective for treating patients with OSAS, there are several confounding issues of CPAP therapy, such as problems with adaptation to devices and compliance [4]. An oral appliance is one superior alternative approach to CPAP for patients suffering from OSAS [5,6].

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