Akiko Tsujisaka1, Shingo Haraki1, Shigeru Nonoue2, Akira Mikami3, Hiroyoshi Adachi3, Takahiro Mizumori1, Hirofumi Yatani1, Atsushi Yoshida4, Takafumi Kato5. 1. Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan. 2. Sleep Medicine Center, Osaka University Hospital, Suita, Japan; Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan. 3. Sleep Medicine Center, Osaka University Hospital, Suita, Japan; Health and Counseling Center, Osaka University, Toyonaka, Japan; Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan. 4. Department of Oral Anatomy and Neurobiology, Osaka University Graduate School of Dentistry, Suita, Japan. 5. Sleep Medicine Center, Osaka University Hospital, Suita, Japan; Department of Oral Anatomy and Neurobiology, Osaka University Graduate School of Dentistry, Suita, Japan; Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan. Electronic address: takafumi@dent.osaka-u.ac.jp.
Abstract
PURPOSE: Concomitant occurrence of respiratory events can be often overlooked in the clinical practice of SB. This study assessed physiological characteristics of rhythmic masticatory muscle activity (RMMA) and concomitant respiratory events in young sleep bruxism (SB) subjects asymptomatic to obstructive sleep apnea (OSA). METHODS: Twenty-two subjects (age: 24.1±1.9years; F 8: M 14; BMI: 20.2±1.9kg/m2) were polysomnographically diagnosed as moderate-severe SB. Sleep architecture, oromotor (RMMA and non-specific masseter activity [NSMA]) and apnea/hypopnea events were scored. RESULTS: All subjects showed normal sleep architecture whereas 6 exhibited respiratory events at a mild level of OSA. In all subjects, RMMA predominantly occurred in Stage N1+N2 while NSMA occurred in Stage N1+N2 (approximately 60 %) and in Stage R (up to 30 %). Up to 50% of respiratory events were scored in Stage R. RMMA occurred more frequently in close association (e.g., within 10s) with respiratory events in 6 subjects with OSA than those without. The percentage of RMMA occurring closely to respiratory events was positively correlated with apnea-hypopnea index (AHI) in Stage N1+N2 only while that of NSMA was positively correlated with AHI in Stage N1+N2 and Stage R. A sub-analysis in 6 subjects with OSA, RMMA after respiratory events was followed to arousals while those before respiratory events were mostly associated with central apnea. CONCLUSIONS: A subpopulation of young SB subjects can show concomitant respiratory events. Further large sample studies are needed to demonstrate that the occurrence of subclinical respiratory events represents a clinical subtype of SB.
PURPOSE: Concomitant occurrence of respiratory events can be often overlooked in the clinical practice of SB. This study assessed physiological characteristics of rhythmic masticatory muscle activity (RMMA) and concomitant respiratory events in young sleep bruxism (SB) subjects asymptomatic to obstructive sleep apnea (OSA). METHODS: Twenty-two subjects (age: 24.1±1.9years; F 8: M 14; BMI: 20.2±1.9kg/m2) were polysomnographically diagnosed as moderate-severe SB. Sleep architecture, oromotor (RMMA and non-specific masseter activity [NSMA]) and apnea/hypopnea events were scored. RESULTS: All subjects showed normal sleep architecture whereas 6 exhibited respiratory events at a mild level of OSA. In all subjects, RMMA predominantly occurred in Stage N1+N2 while NSMA occurred in Stage N1+N2 (approximately 60 %) and in Stage R (up to 30 %). Up to 50% of respiratory events were scored in Stage R. RMMA occurred more frequently in close association (e.g., within 10s) with respiratory events in 6 subjects with OSA than those without. The percentage of RMMA occurring closely to respiratory events was positively correlated with apnea-hypopnea index (AHI) in Stage N1+N2 only while that of NSMA was positively correlated with AHI in Stage N1+N2 and Stage R. A sub-analysis in 6 subjects with OSA, RMMA after respiratory events was followed to arousals while those before respiratory events were mostly associated with central apnea. CONCLUSIONS: A subpopulation of young SB subjects can show concomitant respiratory events. Further large sample studies are needed to demonstrate that the occurrence of subclinical respiratory events represents a clinical subtype of SB.