Daniele Manfredini1, Luca Guarda-Nardini2, Rosario Marchese-Ragona3, Frank Lobbezoo4. 1. Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy. daniele.manfredini@tin.it. 2. Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy. 3. Institute of Otolaryngology, Department of Neurosciences, University of Padova, Padova, Italy. 4. Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Sleep bruxism (SB) is a term covering different motor phenomena with various risk and etiological factors and potentially different clinical relevance, especially as far as its possible protective role against obstructive sleep apnea (OSA) is concerned. The present expert opinion discusses the possible temporal relationships between the two phenomena. METHODS: Four hypothetical scenarios for a temporal relationship may be identified: (1) the two phenomena are unrelated; (2) the onset of the OSA event precedes the onset of the SB event within a limited time span, with SB having a potential OSA-protective role; (3) the onset of the SB event precedes the onset of the OSA event within a limited time span, with SB having an OSA-inducing effect; and (4) the onset of the OSA and SB event occurs at the same moment. RESULTS: Literature findings on the SB-OSA temporal relationship are inconclusive. The most plausible hypothesis is that the above scenarios are all actually possible and that the relative predominance of one specific sequence of events varies at the individual level. SB activity may be protective against OSA by protruding the mandible and restoring airway patency in those subjects who benefit from mandibular advancement strategies or may even be related to OSA induction, as a consequence of airways' mucosae swelling resulting from a SB-induced trigeminal cardiac reflex. CONCLUSIONS: Clinicians should keep in mind that the SB-OSA relationship is complex and that interindividual differences may explain the possible different SB-OSA relationships, with particular regard to the anatomical site of obstruction.
BACKGROUND:Sleep bruxism (SB) is a term covering different motor phenomena with various risk and etiological factors and potentially different clinical relevance, especially as far as its possible protective role against obstructive sleep apnea (OSA) is concerned. The present expert opinion discusses the possible temporal relationships between the two phenomena. METHODS: Four hypothetical scenarios for a temporal relationship may be identified: (1) the two phenomena are unrelated; (2) the onset of the OSA event precedes the onset of the SB event within a limited time span, with SB having a potential OSA-protective role; (3) the onset of the SB event precedes the onset of the OSA event within a limited time span, with SB having an OSA-inducing effect; and (4) the onset of the OSA and SB event occurs at the same moment. RESULTS: Literature findings on the SB-OSA temporal relationship are inconclusive. The most plausible hypothesis is that the above scenarios are all actually possible and that the relative predominance of one specific sequence of events varies at the individual level. SB activity may be protective against OSA by protruding the mandible and restoring airway patency in those subjects who benefit from mandibular advancement strategies or may even be related to OSA induction, as a consequence of airways' mucosae swelling resulting from a SB-induced trigeminal cardiac reflex. CONCLUSIONS: Clinicians should keep in mind that the SB-OSA relationship is complex and that interindividual differences may explain the possible different SB-OSA relationships, with particular regard to the anatomical site of obstruction.
Authors: Luc G T Morris; Omar Burschtin; Jennifer Setlur; Claire C Bommelje; Kelvin C Lee; Joseph B Jacobs; Richard A Lebowitz Journal: Otolaryngol Head Neck Surg Date: 2008-11 Impact factor: 3.497
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Authors: F Lobbezoo; J Ahlberg; K G Raphael; P Wetselaar; A G Glaros; T Kato; V Santiago; E Winocur; A De Laat; R De Leeuw; K Koyano; G J Lavigne; P Svensson; D Manfredini Journal: J Oral Rehabil Date: 2018-06-21 Impact factor: 3.837