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Is there an association between Sleep Bruxism and Obstructive Sleep Apnea syndrome? a systematic review
Sleep bruxism (SB) is a masticatory muscle activity characterized by repetitive clenching or grinding of the teeth and/or by bracing or thrusting of the mandible, usually associated with sleep arousals. Obstructive Sleep Apnea (OSA) is a sleep-related condition and, thus, share a common physiologic pathway with SB. OSA is a respiratory disorder characterized by total (apnea) or partial (hypopnea) airway obstruction leading to arousals in response to respiratory effort.
To elucidate current knowledge on the potential association and causality between Sleep Bruxism (SB) and Obstructive Sleep Apnea (OSA) using full-night polysomnography.
Search strategies were developed to PubMed, Web of Science, Cochrane, LILACS, MEDLINE and BBO-ODO and conducted until May 2019. The methodological quality was evaluated using Qu-ATEBS tool.
Identified 270 articles and after independent screening of abstracts by two authors, 17 articles underwent full text reading. 10 articles were excluded for not meeting inclusion criteria and 7 were included in qualitative synthesis. Four studies support the association between SB and OSA: (a) a subtype of OSA patients may have SB as a protective response to respiratory events (b) most episodes of bruxism occur shortly after the end of apnea / hypopnea (AH) events (c) bruxism episodes occur secondary to arousals arising from AH events (d) there is a correlation between the frequency of SB and AH events. And three studies do not support: (e) AH episodes are related to non-specific SB oromotor activities (f) SB episodes are not directly associated with the end of AH events (g) patients with OSA did not experience more SB events than control group.
There is no scientific evidence to support a conclusive relationship between SB and OSA. Further well-designed and randomized studies with control groups are need to investigate whether possible mechanisms common to SB and OSA exist and whether OSA treatment could improve SB negative oral health outcomes in patients with SB and comorbidity of OSA.
bruxism, obstructive sleep apnea, sleep bruxism, sleep disordered breathing, systematic review
Faculdade de Odontologia - Universidade Federal de Uberlandia - Minas Gerais - Brasil
Thays Crosara Abrahão Cunha, Ana Julia da Costa Lopes, Maria Cecília Magalhães Monteiro, Júnia Serra Negra, Paulo Cézar Simamoto-Junior