Abstract
Obstructive sleep apnea (OSA) is the most common sleep disorder. Sleep bruxism (SB) is a masticatory muscle activity during sleep that commonly co-occurs with OSA. The presented study aimed to assess this relationship and to identify factors affecting this co-occurrence. Adult patients (n = 110) were evaluated for OSA and SB in a sleep laboratory using polysomnography. The episodes of bruxism and respiratory events were scored according to the standards of the American Academy of Sleep Medicine. The prevalence of OSA and SB was found to be 86.37% and 50%, respectively. The bruxism episode index (BEI) was increased in the group with mild and moderate OSA (apnea–hypopnea index (AHI) <30) compared to that in the group with severe OSA (AHI ≥ 30) (5.50 ± 4.58 vs. 1.62 ± 1.28, p < 0.05). A positive correlation between AHI and BEI was observed in the group with AHI < 30. Regression analysis indicated that higher AHI, male gender, and diabetes were independent predictors for the increased BEI in group with AHI < 30. The relationship between OSA and SB depends on the degree of severity of OSA. OSA is correlated with SB in mild and moderate cases of OSA in the group of patients with increased risk of OSA.
Highlights
Obstructive sleep apnea (OSA) is a common sleep disorder characterized by a collapse of the upper airways in the setting of continued respiratory effort, leading to airflow cessation and arterial oxygen desaturation, often terminated by arousal
The International Classification of Sleep Disorders (ICDS-3) indicates the following clinical criteria for the classification of sleep bruxism: (A) the presence of regular or frequent tooth grinding sounds occurring during sleep and (B) the presence of one or more of the following clinical signs: (1) abnormal tooth wear consistent with the above reports of tooth grinding during sleep and (2) transient morning jaw-muscle pain or fatigue; and/or temporal headache; and/or jaw locking upon awakening consistent with the above reports of tooth grinding during sleep [10]
We demonstrated that OSA (AHI ≥ 5), male gender, and diabetes are the independent risk factors for increased bruxism episode index (BEI)
Summary
Obstructive sleep apnea (OSA) is a common sleep disorder characterized by a collapse of the upper airways in the setting of continued respiratory effort, leading to airflow cessation and arterial oxygen desaturation, often terminated by arousal. A relationship between OSA and sleep bruxism (SB) has been previously demonstrated [6]. The prevalence of OSA ranges from 9% to 38% [7], and the prevalence of SB is estimated to occur in 13% of adults [8]. OSA may be one of the most frequent risk factors for SB in the adult population. Emotional stress; certain groups of drugs; consumption of tobacco, alcohol, or coffee; OSA; and anxiety disorders are recognized as important risk factors of bruxism among adults [13]. The association between SB and OSA has been discussed in earlier studies [14,16], these studies have failed to confirm this relationship [15,17]
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