The meaning of the masticatory muscle tonic-type electromyographic pathway correlated with sleep bruxism and sleep-related breathing disorders - A polysomnographic study

Joanna Smardz; Helena Martynowicz; Anna Wojakowska; Monika Michalek-Zrabkowska; Grzegorz Mazur; Tomasz Wieczorek; Mieszko Wieckiewicz

doi:10.1016/j.sleep.2019.08.025

The meaning of the masticatory muscle tonic-type electromyographic pathway correlated with sleep bruxism and sleep-related breathing disorders - A polysomnographic study

Sleep Med. 2020 Apr:68:131-137. doi: 10.1016/j.sleep.2019.08.025. Epub 2019 Oct 2.

Authors

Joanna Smardz¹, Helena Martynowicz², Anna Wojakowska², Monika Michalek-Zrabkowska², Grzegorz Mazur², Tomasz Wieczorek³, Mieszko Wieckiewicz⁴

Affiliations

¹ Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland.
² Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland.
³ Department and Clinic of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
⁴ Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland. Electronic address: m.wieckiewicz@onet.pl.

PMID: 32035303
DOI: 10.1016/j.sleep.2019.08.025

Abstract

Study objectives: The coexistence of sleep-related breathing disorders (SRBD) and sleep bruxism (SB) is often mentioned in the literature. Polysomnography (PSG) with video recording gives the best opportunity to identify both of these phenomena. This study aimed to evaluate the relationship between SRBD and SB.

Methods: Patients from the Clinic of Prosthetic Dentistry operating at Wroclaw Medical University with diagnosed probable SB were subjected to one-night video-polysomnography. PSGs were evaluated according to standard sleep criteria. The results of the examination were analyzed for the occurrence of SB and SRBD. The Bruxism Episodes Index (BEI) and the types of electromyographical pathways (phasic, tonic, mixed) were used to evaluate SB. The Apnea/Hypopnea Index (AHI) and Oxygen Desaturation Index (ODI) were used to assess respiratory events. Subjects were divided into two groups according to SB occurrence: the studied group (bruxers, BEI ≥ 2) and control group (non-bruxers, BEI < 2).

Results: Quantitative analysis showed a lack of a statistically significant relationship between BEI and AHI (p = 0.82) and ODI (p = 0.90) in the studied group and controls. Qualitative analysis showed that the increase in both AHI and ODI was statistically significantly correlated with the increase in the number of tonic types of electromyographical pathways (p = 0.047, p = 0.006, respectively).

Conclusions: This study showed a significant relationship between tonic electromyographic pathways in SB episodes and SRBD. Tonic muscle contractions can be cause and effect for the formation of respiratory events. The occurrence of tonic episodes may be the key to understanding the causal relationship between SB and SRBD and should be more precisely examined.

Clinical trial: Evaluation of Selected Disorders with Sleep Bruxism, www.ClinicalTrials.gov, identifier NCT03083405.

Keywords: Sleep bruxism; Sleep-disordered breathing; Sleep-related breathing disorders; Tonic bruxism; Tonic masticatory muscle activity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Masticatory Muscles
Polysomnography
Sleep
Sleep Apnea, Obstructive*
Sleep Bruxism* / complications
Sleep Bruxism* / diagnosis

Associated data

ClinicalTrials.gov/NCT03083405