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Herberts M, Kolla B, Paul T, Mekala P, Mansukhani MP. Sleep apnea and autonomic dysfunction in patients with dementia. Front Neurosci 2022; 16:951147. [PMID: 36408398 PMCID: PMC9669746 DOI: 10.3389/fnins.2022.951147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Sleep apnea is common sleep disorder that is associated with an is an increase in risk of many health conditions, including systemic hypertension, stroke, atrial fibrillation, and heart failure. The predominant underlying pathophysiological mechanism for elevated risk of these conditions in patients with sleep apnea is thought to involve autonomic dysfunction in the form of sympathetic overactivity. Autonomic dysfunction is also associated with several neurodegenerative disorders and sleep apnea, in turn, has been shown to be associated with an increased risk of development of mild cognitive impairment and various types of dementia. Rapid eye movement sleep behavior disorder, which is also associated with an increased risk of alpha synucleiopathy-related dementia, is also linked with autonomic dysfunction. In this article we explore the relationship between sleep apnea, autonomic dysfunction, rapid eye movement sleep behavior disorder and dementia. This article describes the various autonomic dysfunction that are thought to occur in the context of sleep apnea. And illustrate the mechanisms by which sleep apnea, through its impact on autonomic dysfunction could potentially result in dementia. We also review the evidence examining the impact of treatment of sleep apnea on autonomic dysfunction and cognitive outcomes.
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Affiliation(s)
- Michelle Herberts
- Center for Sleep Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - Travis Paul
- Mayo Clinic Health System, Southwest Minnesota, Mankato, MN, United States
| | - Praveen Mekala
- Mayo Clinic Health System, Southwest Minnesota, Mankato, MN, United States
| | - Meghna P. Mansukhani
- Center for Sleep Medicine, Mayo Clinic, Rochester, MN, United States
- *Correspondence: Meghna P. Mansukhani,
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2
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Polysomnographic Evaluation of Sleep Bruxism Intensity and Sleep Architecture in Nonapneic Hypertensives: A Prospective, Observational Study. J Clin Med 2022; 11:jcm11113113. [PMID: 35683499 PMCID: PMC9181472 DOI: 10.3390/jcm11113113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/22/2022] [Accepted: 05/28/2022] [Indexed: 11/24/2022] Open
Abstract
Sleep bruxism (SB) is a repetitive jaw muscle activity characterized by clenching or grinding of the teeth, which is classified under sleep-related movement disorders in the International Classification of Sleep Disorders—Third Edition. Because the potential common pathomechanism of SB and arterial hypertension is the activation of the sympathetic system as well as an increase in inflammatory factors, we aimed to examine the intensity of SB and the sleep architecture among patients with arterial hypertension. The study included a total of 91 Caucasian adult patients, among whom 31 had arterial hypertension diagnosed according to the current European Society of Cardiology/European Society of Hypertension (ESC/EHS) hypertension guidelines. The control group consisted of 61 normotensive patients. Patients with obstructive sleep apnea were excluded. A single full-night polysomnographic examination was conducted in the Sleep Laboratory, and then the results were analyzed based on the guidelines of the American Academy of Sleep Medicine. Bruxism episode index (BEI) was higher in the hypertensive group compared to normotensives. The groups also showed statistically significant differences in polysomnographic sleep indexes. Similar to BEI, arousal index, apnea–hypopnea index, and snoring were higher in hypertensives compared to normotensives. On the other hand, the mean and minimal oxygen saturation were lower in hypertensives compared to normotensives. A statistically significant positive correlation was observed between oxygen desaturation index and BEI in the hypertensive group, whereas this correlation was not statistically significant in the case of normotensives. In summary, nonapneic hypertensives had higher SB intensity, altered sleep architecture, decreased mean oxygen saturation, and increased snoring compared to normotensives. The results suggest that dental screening is necessary for patients with arterial hypertension, especially those presenting with the symptoms of SB.
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3
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Effect of Sleep Bruxism Intensity on Blood Pressure in Normotensives. J Clin Med 2021; 10:jcm10061304. [PMID: 33810035 PMCID: PMC8004920 DOI: 10.3390/jcm10061304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
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.
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Bhattacharjee B, Saneja R, Bhatnagar A, Gupta P. Effect of dopaminergic agonist group of drugs in treatment of sleep bruxism: A systematic review. J Prosthet Dent 2021; 127:709-715. [PMID: 33455727 DOI: 10.1016/j.prosdent.2020.11.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 01/02/2023]
Abstract
STATEMENT OF PROBLEM Various factors are responsible for sleep bruxism; however, whether the dopaminergic agonist group of drugs is effective in the treatment of sleep bruxism is unclear. PURPOSE The purpose of this systematic review was to evaluate the effect of the dopaminergic agonist group of drugs in controlling sleep bruxism in comparison with no treatment or placebo-controlled treatment. MATERIAL AND METHODS Two electronic databases, PubMed and Cochrane Central, were searched by using the keywords bruxism, sleep bruxism, dopamine, and dopamine agonist. After screening titles and abstracts, only those articles which met predefined inclusion criteria were selected for full-text assessment. Clinical trials using the dopaminergic agonist group of drugs as a treatment approach to sleep bruxism were included. RESULTS The literature search yielded a total of 64 articles from the 2 electronic databases (PubMed, 53; Cochrane Central, 11). After removal of the duplicates (n=8), the initial screening of titles and abstracts was performed by 2 independent reviewers, removing 46 articles. A total of 10 articles were selected for full-text reading, and 4 studies were included for qualitative analysis. CONCLUSIONS Levodopa (L-DOPA) and Bromocriptine showed decrease in root mean square value in electromyography per bruxism burst (P<.001) and 20% to 30% reduction of bruxism episodes during sleep in 2 different studies. However, treatment with bromocriptine led to conflicting result in another study in terms of frequency of bruxism episodes and amplitude of muscle contractions in electromyography (EMG). Bruxism bursts and episodes were also not significantly improved with another dopaminergic agonist group of drugs, Pramipexole (P>.001). Based on the limited evidence and conflicting results, significant conclusions cannot be generated, and further studies are required.
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Affiliation(s)
- Bappaditya Bhattacharjee
- Junior Resident, Department of Prosthodontics, Faculty of Dental sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
| | - Ritu Saneja
- Junior Resident, Department of Prosthodontics, Faculty of Dental sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Atul Bhatnagar
- Professor, Department of Prosthodontics, Faculty of Dental sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Pinki Gupta
- Junior Resident, Department of Prosthodontics, Faculty of Dental sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Michalek-Zrabkowska M, Wieckiewicz M, Macek P, Gac P, Smardz J, Wojakowska A, Poreba R, Mazur G, Martynowicz H. The Relationship between Simple Snoring and Sleep Bruxism: A Polysomnographic Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8960. [PMID: 33276496 PMCID: PMC7731201 DOI: 10.3390/ijerph17238960] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022]
Abstract
Simple snoring is defined as the production of sound in the upper aerodigestive tract during sleep, not accompanied by other pathologies. Sleep bruxism (SB) refers to repetitive phasic, tonic, or mixed masticatory muscle activity during sleep. In this study, we investigated the relationship between simple snoring and SB in patients without obstructive sleep apnea (OSA). A total of 565 snoring subjects underwent polysomnography. After examination, individuals with OSA were excluded from the study group. Finally, 129 individuals were analyzed. The bruxism episode index was positively correlated with maximum snore intensity. Phasic bruxism was positively correlated with snore intensity in all sleep positions. Bruxers had a significantly decreased average and minimum heart rate compared with non-bruxers. Supine sleep position seemed to have a significant impact on snore intensity and SB. In summary, our study showed the relationship between SB, snore intensity, and body position. Phasic bruxism was positively correlated with snore intensity despite the body position, which is an interesting and novel finding.
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Affiliation(s)
- Monika Michalek-Zrabkowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland;
| | - Piotr Macek
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Pawel Gac
- Department of Hygiene, Wroclaw Medical University, 7 Mikulicza-Radeckiego St., 50-345 Wroclaw, Poland;
| | - Joanna Smardz
- Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland;
| | - Anna Wojakowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Rafal Poreba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Helena Martynowicz
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
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6
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Miralles R, Valenzuela S, Marambio C, Gamboa NA, Fuentes AD, Santander H, Gutiérrez MF, Zúñiga C, Bull R. Effect of laterotrusive occlusal scheme on chewing duration, external intercostal muscular activity, heart rate, and oxygen saturation. Cranio 2020; 40:401-408. [PMID: 32362247 DOI: 10.1080/08869634.2020.1757893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To evaluate the effect of the laterotrusive occlusal scheme on chewing duration, external intercostal (EIC) electromyographic (EMG) activity, heart rate (HR), and oxygen saturation (OS) during different tasks in the upright seated position.Methods: Fifty young participants, 25 with canine guidance and 25 with group function, were included. Chewing duration, bilateral EIC EMG activity, HR, and OS were recorded during the following tasks: 1) chewing until swallowing threshold; 2) laterotrusive teeth grinding.Results: Chewing duration, bilateral EIC EMG activity, HR, and OS showed no significant differences between the two laterotrusive occlusal schemes during the tasks studied.Conclusion: These results suggest that chewing duration, EIC muscle activity, HR, and OS were not significantly influenced by the laterotrusive occlusal scheme. Therefore, when a modification of the laterotrusive occlusal scheme is needed during oral rehabilitation or orthodontic treatment, canine guidance or group function should not significantly change EMG activity of EIC muscles.
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Affiliation(s)
- Rodolfo Miralles
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile, Santiago, Chile
| | - Saúl Valenzuela
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile, Santiago, Chile.,Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
| | - Camila Marambio
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
| | - Natalia Andrea Gamboa
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile, Santiago, Chile.,Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
| | - Aler Daniel Fuentes
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile, Santiago, Chile.,Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
| | - Hugo Santander
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile, Santiago, Chile
| | - Mario Felipe Gutiérrez
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile, Santiago, Chile.,Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
| | - Claudia Zúñiga
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile, Santiago, Chile.,Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
| | - Ricardo Bull
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile, Santiago, Chile
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7
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Zhong Z, Xu M, Zou X, Ouyang Q, Zhang L, Yu B, Wang K, Yao D. Changes in heart rate related to rhythmic masticatory muscle activities and limb movements in patients with sleep bruxism. J Oral Rehabil 2019; 47:170-179. [PMID: 31697853 DOI: 10.1111/joor.12900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/05/2019] [Accepted: 10/29/2019] [Indexed: 12/19/2022]
Abstract
Most sleep bruxism (SB) episodes are accompanied by an increase in sympathetic tone and heart rate (HR). To characterise heart rate (HR) changes in relation to rhythmic masticatory muscle activities (RMMAs) in SB patients, polysomnographic recordings were performed on 10 SB patients and 11 normal controls. The duration of movement events, amplitude and duration of HR increases, and time to reach HR peak associated with RMMAs and limb movements (LMs) were determined, and the relationships of the parameters of HR increases with types of movements and RMMAs were analysed. All of the parameters of HR increases associated with three types of movements (RMMAs, RMMAs + LMs and LMs) and masseter activities (phasic, tonic and mixed) were significantly different (two-way ANOVA, P < .001 for all) in both SB patients and controls. The duration of RMMAs/LMs was positively correlated with the parameters (SB patients: R2 = .24-.85, P < .0001; controls: R2 = .23-.68, P < .0001). The amplitude of HR increases was also positively correlated with respiration changes in the SB patients (R2 = .3258, P < .0001) and controls (R2 = .09469, P < .05). The proportions of phasic RMMAs associated with awakenings, microarousals and no cortical arousals were significantly different and so were the proportions of tonic and mixed RMMAs (Friedman's tests, P < .05-.001). The HR increases associated with RMMAs may be intrinsic to the cortical arousal response and autonomic activation, and differences in HR increases associated with different types of movements and RMMAs might be related to the changes in respiration and differences in cortical arousal levels.
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Affiliation(s)
- Zhijun Zhong
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
| | - Miao Xu
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
| | - Xueliang Zou
- Jiangxi Mental Hospital, Nanchang University, Jiangxi, China
| | - Qian Ouyang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
| | - Ling Zhang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
| | - Bin Yu
- Jiangxi Mental Hospital, Nanchang University, Jiangxi, China
| | - Kelun Wang
- Department of Health Science & Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
| | - Dongyuan Yao
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
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8
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Abstract
Hypertension is a major determinant of cardiovascular morbidity and mortality and is highly prevalent in the general population. While the relationship between sleep apnea and increased blood pressure has been well documented, less recognized is emerging evidence linking sleep-related movement disorders such as restless legs syndrome/periodic limb movements of sleep and sleep-related bruxism with blood pressure (BP) dysregulation and hypertension. There is also recent literature linking narcolepsy-cataplexy with elevated BP and altered pressor responses, and there are data suggesting abnormal BP control in rapid eye movement sleep behavior disorder. It is thought that neural circulatory mechanisms, sympathetic activation in particular, comprise the predominant mediator underlying elevated BP in these neurological sleep disorders. There is very limited evidence that treating these sleep disorders may be beneficial in lowering BP primarily because this question has received very little attention. In this review, we discuss the potential pathophysiologic mechanisms underlying elevated BP in restless legs syndrome/periodic limb movements of sleep, sleep-related bruxism, narcolepsy-cataplexy, and rapid eye movement sleep behavior disorder. We also examine the relationship between these sleep disorders and elevated BP and the impact of treatment of these conditions on BP control. Last, we discuss gaps in the literature evaluating the associations between these sleep disorders and elevated BP and identify areas for further research.
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Affiliation(s)
- Meghna P. Mansukhani
- Center for Sleep Medicine, Mayo Clinic; Address: 200, First Street SW, Rochester, Minnesota
| | - Naima Covassin
- Department of Cardiovascular Diseases, Mayo Clinic; Address: 200, First Street SW, Rochester, Minnesota
| | - Virend K. Somers
- Department of Cardiovascular Diseases, Mayo Clinic; Address: 200, First Street SW, Rochester, Minnesota
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9
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Lu J, Zhang Y, Han K, Wang C, Zhong Z, Xu M, Zou X, Yu B, Yao D. Heart rate changes associated with rhythmic masticatory muscle activities and limb movements in sleep bruxers: Preliminary findings. Cranio 2019; 39:47-57. [PMID: 30774008 DOI: 10.1080/08869634.2019.1578032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objective: To investigate the relationship of rhythmic masticatory muscle activities (RMMAs) and limb movements (LMs) with heart rate (HR) acceleration. Methods: The amplitude and duration of HR increases, the time to reach peak HR associated with RMMAs/LMs during sleep, duration of movement events, and their relationships with cortical arousal levels were determined in 9 sleep bruxers and 10 normal controls. Results: A total of 48.15% and 49.44% HR increased before the onset of RMMAs/LMs in the sleep bruxers and controls, respectively. All of the parameters of HR increases were significantly different between the sleep bruxers and the controls (p < 0.05-0.001) and between different cortical arousal levels (p < 0.01), and the duration of RMMAs/LMs was positively correlated with the parameters (Sleep bruxers: r2 = 0.18-0.88, p < 0.0001; Controls: r2 = 0.16-0.78, p < 0.0001). Discussion: These data suggest the HR increases are associated with the movement events and changes in cortical arousal levels in the sleep bruxers and controls. Abbreviations: LMs: Limb movements; HR: Heart rate; RMMAs: Rhythmic masticatory muscle activities; SB: Sleep bruxism; PSG: Polysomnographic; EEG: Electroencephalographic; PLMS: Periodic leg movements; SSRIs: Selective serotonin reuptake inhibitors; ECG: Electrocardiographic; EOG: Electrooculographic; EMG: Electromyographic; SD: Standard deviation; Fig: Figure; SEM: Standard error of mean; N1: Non-rapid eye movement sleep stage 1; N2: Non-rapid eye movement sleep stage 2; N3: Non-rapid eye movement sleep stage 3; REM: Rapid eye movement ; NA: No arousal; mAR: Microarousal; AW: Awakening.
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Affiliation(s)
- Junlan Lu
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital , Nanchang, PR China.,School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
| | - Yangping Zhang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital , Nanchang, PR China.,School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
| | - Kangning Han
- Queen Mary College, Nanchang University , Nanchang, PR China
| | - Chuanying Wang
- Queen Mary College, Nanchang University , Nanchang, PR China
| | - Zhijun Zhong
- School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
| | - Miao Xu
- School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
| | - Xueliang Zou
- Jiangxi Mental Hospital, Nanchang University , Nanchang, PR China
| | - Bin Yu
- Jiangxi Mental Hospital, Nanchang University , Nanchang, PR China
| | - Dongyuan Yao
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital , Nanchang, PR China.,School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
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10
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Valenzuela S, Miralles R, Muñoz MI, Santander H, Zúñiga C, Cavada G, Bull R, Gamboa NA, Fuentes AD. Awake teeth grinding in participants with canine guidance or group function: Effect on diaphragm EMG activity, heart rate, and oxygen saturation. Cranio 2019; 38:412-418. [PMID: 30696376 DOI: 10.1080/08869634.2019.1572283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To compare the effect of canine guidance or group function on diaphragm activity, heart rate, and oxygen saturation during awake teeth grinding at different body positions. Methods: Fifty healthy participants, 25 with canine guidance and 25 with group function, were included. Bilateral electromyographic (EMG) recordings of the diaphragm (DIA) during awake teeth grinding were performed in standing, seated upright, and right lateral decubitus positions. Simultaneously, heart rate and oxygen saturation were measured. Results: EMG activity of the DIA muscle was similar in the working side and non-working side between participants with canine guidance and group function in the different body positions studied. The heart rate and oxygen saturation showed no significant differences between the two groups. Conclusion: EMG activity of the DIA muscle, the heart rate, and oxygen saturation during teeth grinding are not significantly influenced by the type of laterotrusive occlusal scheme.
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Affiliation(s)
- Saúl Valenzuela
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile , Santiago, Chile.,Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile , Santiago, Chile
| | - Rodolfo Miralles
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile , Santiago, Chile
| | - María Ignacia Muñoz
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile , Santiago, Chile
| | - Hugo Santander
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile , Santiago, Chile
| | - Claudia Zúñiga
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile , Santiago, Chile.,Faculty of Dentistry, Universidad Finis Terrae
| | - Gabriel Cavada
- Faculty of Medicine, Public Health School, University of Chile , Santiago, Chile
| | - Ricardo Bull
- Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile , Santiago, Chile
| | - Natalia Andrea Gamboa
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile , Santiago, Chile.,Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile , Santiago, Chile
| | - Aler Daniel Fuentes
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile , Santiago, Chile.,Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute, University of Chile , Santiago, Chile
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11
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Martynowicz H, Dymczyk P, Dominiak M, Kazubowska K, Skomro R, Poreba R, Gac P, Wojakowska A, Mazur G, Wieckiewicz M. Evaluation of Intensity of Sleep Bruxism in Arterial Hypertension. J Clin Med 2018; 7:jcm7100327. [PMID: 30301160 PMCID: PMC6210463 DOI: 10.3390/jcm7100327] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 09/28/2018] [Accepted: 10/03/2018] [Indexed: 01/22/2023] Open
Abstract
Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or non-rhythmic (tonic). The recent hypothesis on the etiology of SB supports the role of the central and autonomic nervous systems. Therefore, in this study, we aimed to assess the intensity of SB in patients with arterial hypertension. A total of 70 adults participated in this study: 35 patients with hypertension (study group) and 35 normotensive subjects (control group). Data were recorded using home portable cardiorespiratory polygraphy. The bruxism episode index (BEI) in the study group was found to be significantly higher compared to the control group (3.4 ± 3.25 vs. 2.35 ± 2.29, p = 0.04). Hypertension, higher body mass index (BMI), lower values of mean oxygen saturation (SpO2), and a higher percentage of SpO2 < 90% constituted independent risk factors for increased BEI. These results suggest the need for special oral care in hypertensive patients, patients with higher BMI, lower values of SpO2 and a higher percentage of SpO2 < 90%.
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Affiliation(s)
- Helena Martynowicz
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland.
| | - Pawel Dymczyk
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland.
| | - Marzena Dominiak
- Department of Oral Surgery, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland.
| | - Klaudia Kazubowska
- Department of Oral Surgery, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland.
| | - Robert Skomro
- Division of Respiratory, Critical Care and Sleep Medicine, University of Saskatchewan, 107 Wiggins Road, SK S7N 5E5 Saskatoon, Saskatchewan, Canada.
| | - Rafal Poreba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland.
| | - Paweł Gac
- Department of Hygiene, Wroclaw Medical University, 7 Mikulicza-Radeckiego St., 50-345 Wroclaw, Poland.
| | - Anna Wojakowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland.
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland.
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland.
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Dumais IE, Lavigne GJ, Carra MC, Rompré PH, Huynh NT. Could transient hypoxia be associated with rhythmic masticatory muscle activity in sleep bruxism in the absence of sleep-disordered breathing? A preliminary report. J Oral Rehabil 2015; 42:810-8. [PMID: 26139077 DOI: 10.1111/joor.12323] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2015] [Indexed: 12/20/2022]
Abstract
Sleep bruxism (SB) is a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth during sleep. Sleep bruxism activity is characterised by rhythmic masticatory muscle activity (RMMA). Many but not all RMMA episodes are associated with sleep arousal. The aim of this study was to evaluate whether transient oxygen saturation level change can be temporally associated with genesis of RMMA/SB. Sleep laboratory or home recordings data from 22 SB (tooth grinding history in the absence of reported sleep-disordered breathing) and healthy subjects were analysed. A total of 143 RMMA/SB episodes were classified in four categories: (i) no arousal + no body movement; (ii) arousal + no body movement; (iii) no arousal + body movement; (iv) arousal + body movement. Blood oxygen levels (SaO2 ) were assessed from finger oximetry signal at the baseline (before RMMA), and during RMMA. Significant variation in SaO2 over time (P = 0·001) was found after RMMA onset (+7 to +9 s). No difference between categories (P = 0·91) and no interaction between categories and SaO2 variation over time (P = 0·10) were observed. SaO2 of six of 22 subjects (27%) remained equal or slight increase after the RMMA/SB onset (+8 s) compared to baseline; 10 subjects (45%) slightly decreased (drop 0·01-1%) and the remaining (27%) decreased between 1% and 2%. These preliminary findings suggest that a subgroup of SB subjects had (i) a minor transient hypoxia potentially associated with the onset of RMMA episodes, and this (ii) independently of concomitant sleep arousal or body movements.
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Affiliation(s)
- I E Dumais
- Faculté de médecine dentaire, Université de Montréal, Montréal, QC, Canada
| | - G J Lavigne
- Faculté de médecine dentaire, Université de Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, Montréal, QC, Canada
| | - M C Carra
- Faculté de médecine dentaire, Université de Montréal, Montréal, QC, Canada
| | - P H Rompré
- Faculté de médecine dentaire, Université de Montréal, Montréal, QC, Canada
| | - N T Huynh
- Faculté de médecine dentaire, Université de Montréal, Montréal, QC, Canada
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Masuko AH, Villa TR, Pradella-Hallinan M, Moszczynski AJ, Carvalho DDS, Tufik S, do Prado GF, Coelho FMS. Prevalence of bruxism in children with episodic migraine--a case-control study with polysomnography. BMC Res Notes 2014; 7:298. [PMID: 24886343 PMCID: PMC4026587 DOI: 10.1186/1756-0500-7-298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 04/29/2014] [Indexed: 11/18/2022] Open
Abstract
Background Parents of children with migraine have described a higher prevalence of sleep bruxism and other sleep disturbances in their children. The objective of this study was to use polysomnography to investigate the prevalence of bruxism during sleep in children with episodic migraine relative to controls. Findings Controls and patients were matched by sex, age, years of formal education, presence of snoring, arousals per hour, and respiratory events per hour. A total of 20 controls, between 6 and 12 years old, with no history of headache, recruited from public schools in Sao Paulo between 2009 and 2012, and 20 patients with episodic migraine recruited from the Headache Clinic at the Federal University of Sao Paulo between 2009 and 2012 underwent polysomnography. No intervention was performed before sleep studies. Among migraine patients, 27.5% experienced aura prior to migraine onset. The sleep efficiency, sleep latency, REM sleep latency, arousals per hour, percentage of sleep stages, and breathing events per hour were similar between groups. Five children (25%) with episodic migraine exhibited bruxism during the sleep study while this finding was not observed in any control (p = 0.045). Conclusions Our data demonstrate that bruxism during sleep is more prevalent in children with episodic migraine. Further prospective studies will help elucidate the underlying shared pathogenesis between bruxism and episodic migraine in children.
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Ilovar S, Zolger D, Castrillon E, Car J, Huckvale K. Biofeedback for treatment of awake and sleep bruxism in adults: systematic review protocol. Syst Rev 2014; 3:42. [PMID: 24886985 PMCID: PMC4028105 DOI: 10.1186/2046-4053-3-42] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/31/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bruxism is a disorder of jaw-muscle activity characterised by repetitive clenching or grinding of the teeth which results in discomfort and damage to dentition. The two clinical manifestations of the condition (sleep and awake bruxism) are thought to have unrelated aetiologies but are palliated using similar techniques. The lack of a definitive treatment has prompted renewed interest in biofeedback, a behaviour change method that uses electronic detection to provide a stimulus whenever bruxism occurs. This systematic review aims to provide a comprehensive overview of the state of research into biofeedback for bruxism; to assess the efficacy and acceptability of biofeedback therapy in management of awake bruxism and, separately, sleep bruxism in adults; and to compare findings between the two variants. METHODS A systematic review of published literature examining biofeedback as an intervention directed at controlling primary bruxism in adults. We will search electronic databases and the grey literature using a predefined search strategy to identify randomised and non-randomised studies, technical reports and patents. Searches will not be restricted by language or date and will be expanded through contact with authors and experts, and by following up reference lists and citations. Two authors, working independently, will conduct screening of search results, study selection, data extraction and quality assessment and a third will resolve any disagreements. The primary outcomes of acceptability and effectiveness will be assessed using only randomised studies, segregated by bruxism subtype. A meta-analysis of these data will be conducted only if pre-defined conditions for quality and heterogeneity are met, otherwise the data will be summarized in narrative form. Data from non-randomised studies will be used to augment a narrative synthesis of the state of technical developments and any safety-related issues. PROSPERO registration number: CRD42013006880. DISCUSSION Biofeedback is not new, but its place in the clinical management of bruxism remains unclear. New research, and the availability of miniaturized consumer-grade devices, makes a systematic review timely to guide treatment decisions and inform future research.
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Affiliation(s)
| | | | | | | | - Kit Huckvale
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, 306 The Reynolds Building, St Dunstan's Road, London W6 8RP, UK.
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Ishida JI, Wada Y, Imai Y, Hirata Y, Yamashita M, Kirita T. Influence of mouth guards on autonomic nervous system activities: A quantitative study of pupillary flash responses. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s1348-8643(12)00026-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nashed A, Lanfranchi P, Rompré P, Carra MC, Mayer P, Colombo R, Huynh N, Lavigne G. Sleep bruxism is associated with a rise in arterial blood pressure. Sleep 2012; 35:529-36. [PMID: 22467991 PMCID: PMC3296795 DOI: 10.5665/sleep.1740] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Sleep bruxism (SB) is a movement disorder identified by grinding of teeth and rhythmic masticatory muscle activity (RMMA). RMMA is associated with body movements and cortical arousals. Increases in autonomic sympathetic activities that characterize sleep cortical arousal precede RMMA/SB. Based on these findings, this study examined whether RMMA/SB episodes are also associated with significant changes in arterial blood pressure (BP). DESIGN Participants underwent 3 nights of full polysomnography that included noninvasive beat-to-beat BP recording. Single RMMA/SB episodes and arousal episodes were analyzed in stage 2 sleep and categorized as: (i) RMMA/SB + arousal; (ii) RMMA/SB + body movement; (iii) RMMA/SB + arousal + body movement; or (iv) arousal alone. Sleep and RMMA/SB data were compared to a Non SB group. RMMA/SB clusters (RMMA/SB episodes ≤ 30 sec apart) were also analyzed. SETTING Sleep Laboratory at l'Hôpital du Sacré-Coeur de Montréal. PARTICIPANTS Ten young, healthy participants with SB (mean age = 26 ± 1.8 years) and 9 without SB (mean age = 29 ± 1.2 years). INTERVENTIONS N/A MEASUREMENTS AND RESULTS: BP increased with all RMMA/SB and arousal episodes (P ≤ 0.05). The average maximum BP surges (systolic/diastolic ± SE mm Hg) were: 25.6 ± 3.3/12.6 ± 2.0 for RMMA/SB + arousal; 30.1 ± 1.7/19.1 ± 1.9 for RMMA/SB + body movement; 26.0 ± 2.8/15.1 ± 2.0 for RMMA/SB + arousal + body movement; 19.4 ± 2.3/8.9 ± 1.2 for arousal alone; and for RMMA/SB clusters: Episode: 1: 26.2 ± 8.7/16.4 ± 5.7; Episode 2: 21.1 ± 7.9/12.6 ± 6.4. CONCLUSION Rhythmic masticatory muscle activity/sleep bruxism (RMMA/SB) is associated with blood pressure fluctuations during sleep. Arousals and body movements often occur with RMMA/SB and can impact the magnitude of this BP surge.
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Affiliation(s)
- Angela Nashed
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
| | - Paola Lanfranchi
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
| | - Pierre Rompré
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
| | - Maria Clotilde Carra
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
| | - Pierre Mayer
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Clinique du Sommeil, Hotel Dieu, Montréal, Quebec, Canada
| | - Roberto Colombo
- Department of Bioengineering, Salvatore Maugeri Foundation, IRCCS, Veruno Italy
| | - Nelly Huynh
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
| | - Gilles Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Clinique du Sommeil, Hotel Dieu, Montréal, Quebec, Canada
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Carra MC, Huynh N, Lavigne G. Sleep bruxism: a comprehensive overview for the dental clinician interested in sleep medicine. Dent Clin North Am 2012; 56:387-413. [PMID: 22480810 DOI: 10.1016/j.cden.2012.01.003] [Citation(s) in RCA: 149] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sleep bruxism (SB) is a common sleep-related motor disorder characterized by tooth grinding and clenching. SB diagnosis is made on history of tooth grinding and confirmed by polysomnographic recording of electromyographic (EMG) episodes in the masseter and temporalis muscles. The typical EMG activity pattern in patients with SB is known as rhythmic masticatory muscle activity (RMMA). The authors observed that most RMMA episodes occur in association with sleep arousal and are preceded by physiologic activation of the central nervous and sympathetic cardiac systems. This article provides a comprehensive review of the cause, pathophysiology, assessment, and management of SB.
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Affiliation(s)
- Maria Clotilde Carra
- Faculty of Dental Medicine, Univeristé de Montréal, CP 6128 Succursale Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.
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Carra MC, Macaluso GM, Rompré PH, Huynh N, Parrino L, Terzano MG, Lavigne GJ. Clonidine has a paradoxical effect on cyclic arousal and sleep bruxism during NREM sleep. Sleep 2011; 33:1711-6. [PMID: 21120152 DOI: 10.1093/sleep/33.12.1711] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
STUDY OBJECTIVE Clonidine disrupts the NREM/REM sleep cycle and reduces the incidence of rhythmic masticatory muscle activity (RMMA) characteristic of sleep bruxism (SB). RMMA/SB is associated with brief and transient sleep arousals. This study investigates the effect of clonidine on the cyclic alternating pattern (CAP) in order to explore the role of cyclic arousal fluctuation in RMMA/SB. DESIGN Polysomnographic recordings from a pharmacological study. SETTING University sleep research laboratory. PARTICIPANTS AND INTERVENTIONS Sixteen SB subjects received a single dose of clonidine or placebo at bedtime in a crossover design. MEASUREMENTS AND RESULTS Sleep variables and RMMA/SB index were evaluated. CAP was scored to assess arousal instability between sleep-maintaining processes (phase A1) and stronger arousal processes (phases A2 and A3). Paired t-tests, ANOVAs, and cross-correlations were performed. Under clonidine, CAP time, and particularly the number of A3 phases, increased (P≤0.01). RMMA/SB onset was time correlated with phases A2 and A3 for both placebo and clonidine nights (P≤0.004). However, under clonidine, this positive correlation began up to 40 min before the RMMA/SB episode. CONCLUSIONS CAP phase A3 frequency increased under clonidine, but paradoxically, RMMA/SB decreased. RMMA/SB was associated with and facilitated in CAP phase A2 and A3 rhythms. However, SB generation could be influenced by other factors besides sleep arousal pressure. NREM/REM ultradian cyclic arousal fluctuations may be required for RMMA/SB onset.
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Affiliation(s)
- Maria Clotilde Carra
- Faculté de Médecine Dentaire, Université de Montréal, and Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
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CARRA MC, ROMPRÉ PH, KATO T, PARRINO L, TERZANO MG, LAVIGNE GJ, MACALUSO GM. Sleep bruxism and sleep arousal: an experimental challenge to assess the role of cyclic alternating pattern. J Oral Rehabil 2011; 38:635-42. [DOI: 10.1111/j.1365-2842.2011.02203.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abekura H, Tsuboi M, Okura T, Kagawa K, Sadamori S, Akagawa Y. Association between sleep bruxism and stress sensitivity in an experimental psychological stress task. Biomed Res 2011; 32:395-9. [DOI: 10.2220/biomedres.32.395] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Okada Y, Kamijo YI, Okazaki K, Masuki S, Goto M, Nose H. Pressor responses to isometric biting are evoked by somatosensory receptors in periodontal tissue in humans. J Appl Physiol (1985) 2009; 107:531-9. [PMID: 19478191 DOI: 10.1152/japplphysiol.91199.2008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Jaw muscle contraction, such as mastication and biting (BT), is known to evoke pressor responses. We examined whether the responses were evoked by somatosensory receptors in periodontal tissue and, moreover, whether they were accompanied by altered arterial baroreflex sensitivity. In the first experiment, we measured mean arterial pressure, heart rate, and muscle sympathetic nerve activity from the peroneal nerve during 2-min isometric BT at 50% maximal voluntary contraction before [control (CNT)] and after pharmacological alveolar nerve block (BLK) in eight young men, while monitoring finger cutaneous vascular conductance, gingival vascular conductance (GVC), surface electromyogram of masseter muscle, and BT force. In the second experiment, cardiac and sympathetic baroreflex sensitivities were successfully determined in eight and five of the subjects, respectively, by the modified Oxford method during 5-min BT at 30% maximal voluntary contraction and also during resting without BT in CNT and BLK, respectively. In the first experiment, although BT in CNT and BLK significantly increased mean arterial pressure, heart rate, and total muscle sympathetic nerve activity (burst amplitude x burst incidence), and decreased finger cutaneous vascular conductance and GVC (P<0.05), all changes except GVC were markedly attenuated in BLK (P<0.05). There were no significant differences in integrated electromyogram and BT force among any trials. In the second experiment, although BT in CNT significantly decreased cardiac and sympathetic baroreflex sensitivities (both, P<0.05), these changes disappeared in BLK. These results suggest that somatosensory receptors in periodontal tissue were involved in pressor responses to isometric BT, which was accompanied by decreased arterial baroreflex sensitivity.
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Affiliation(s)
- Yoshiyuki Okada
- Department of Sports Medical Sciences, Institute on Aging and Adaptation, Shinshu University Graduate School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan
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Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K. Bruxism physiology and pathology: an overview for clinicians. J Oral Rehabil 2009; 35:476-94. [PMID: 18557915 DOI: 10.1111/j.1365-2842.2008.01881.x] [Citation(s) in RCA: 412] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Awake bruxism is defined as the awareness of jaw clenching. Its prevalence is reported to be 20% among the adult population. Awake bruxism is mainly associated with nervous tic and reactions to stress. The physiology and pathology of awake bruxism is unknown, although stress and anxiety are considered to be risk factors. During sleep, awareness of tooth grinding (as noted by sleep partner or family members) is reported by 8% of the population. Sleep bruxism is a behaviour that was recently classified as a 'sleep-related movement disorder'. There is limited evidence to support the role of occlusal factors in the aetiology of sleep bruxism. Recent publications suggest that sleep bruxism is secondary to sleep-related micro-arousals (defined by a rise in autonomic cardiac and respiratory activity that tends to be repeated 8-14 times per hour of sleep). The putative roles of hereditary (genetic) factors and of upper airway resistance in the genesis of rhythmic masticatory muscle activity and of sleep bruxism are under investigation. Moreover, rhythmic masticatory muscle activity in sleep bruxism peaks in the minutes before rapid eye movement sleep, which suggests that some mechanism related to sleep stage transitions exerts an influence on the motor neurons that facilitate the onset of sleep bruxism. Finally, it remains to be clarified when bruxism, as a behaviour found in an otherwise healthy population, becomes a disorder, i.e. associated with consequences (e.g. tooth damage, pain and social/marital conflict) requires intervention by a clinician.
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Affiliation(s)
- G J Lavigne
- Faculty of Dentistry, Surgery Department, Pain, Sleep and Trauma Unit, Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada.
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Schaffernocker T, Ho J, Hayes D. Sleep-associated movement disorders and heart failure. Heart Fail Rev 2008; 14:165-70. [PMID: 19051011 DOI: 10.1007/s10741-008-9118-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Accepted: 10/14/2008] [Indexed: 11/29/2022]
Abstract
Sleep-associated movement disorders are a broad group of sleep disorders characterized by involuntary movements that may disrupt sleep. Relatively little is known about the clinical consequences of sleep-associated movement disorders on cardiovascular health. Because these disorders manifest mostly during sleep, recognizing a movement disorder can be particularly difficult. Nevertheless, patients can have frequent arousals and suffer from similar sleep deprivation, fragmentation, and autonomic disruption as occurs in sleep-disordered breathing. Subsequently, these disorders may have a serious impact on daytime function and perception of health in patients with chronic heart failure.
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Affiliation(s)
- Troy Schaffernocker
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Medical Center, 201 Davis HLRI, 473 West 12th Avenue, Columbus, OH 43210, USA.
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Khoury S, Rouleau GA, Rompré PH, Mayer P, Montplaisir JY, Lavigne GJ. A Significant Increase in Breathing Amplitude Precedes Sleep Bruxism. Chest 2008; 134:332-337. [DOI: 10.1378/chest.08-0115] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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AHLBERG K, SAVOLAINEN A, PAJU S, HUBLIN C, PARTINEN M, KNNEN M, AHLBERG J. Bruxism and sleep efficiency measured at home with wireless devices. J Oral Rehabil 2008; 35:567-71. [DOI: 10.1111/j.1365-2842.2008.01875.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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In response: bruxism and autonomic activity. Clin Auton Res 2006. [DOI: 10.1007/s10286-006-0381-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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