Prevalence and predictors of sleep bruxism in patients with obstructive sleep apnea and the effect of positive airway pressure treatment.
Level 4 - case-series / case-control
Retrospective pre-post observational case series without an independent control group
PubMed 38172271 · doi:10.1007/s11325-023-02985-z
What was done
A retrospective study of 100 randomly selected patients with obstructive sleep apnea (OSA; mean age 50.8 ± 16.7 years, 73% male) who underwent split-night polysomnography between August 2021 and October 2022. Investigators evaluated the prevalence and predictors of sleep bruxism (SB) and severe SB (sleep bruxism index [SBI] ≥ 4), assessed SB episodes temporally related (within 5 s) to obstructive respiratory events, and compared SBI between the diagnostic baseline portion and optimal positive airway pressure (PAP) titration.
What was found
Baseline SB was detected in 49% of patients (49/100), with severe SB present in 31%; 73.5% of SB episodes were associated with OSA events. Self-reported nocturnal tooth grinding predicted overall SB (OR 5.69, 95% CI 1.74–18.58), severe SB (OR 9.63, 95% CI 2.54–36.42), and OSA-associated SB (OR 5.4, 95% CI 1.22–23.93). Male sex was associated with severe SB (OR 4.01, 95% CI 1.02–15.88), and non-supine respiratory disturbance index predicted OSA-associated SB (OR 1.02, 95% CI 1.001–1.034). Among patients with SB, optimal PAP significantly reduced median SBI from 5.5 (IQR 3.2–9.3) to 0 (IQR 0–2.1) events/h (median difference 4.4, p < 0.001).
Why it matters
These findings suggest that sleep bruxism frequently co-occurs with OSA and is largely triggered by obstructive events, and that acute airway stabilization with PAP significantly reduces bruxism frequency.
Limits
The study had a retrospective, single-center design with a modest sample size of 100 patients. The split-night protocol provided only brief observation periods for both baseline sleep and PAP titration, and long-term clinical efficacy and adherence were not assessed.
Cited by
- supports Teeth grinding (bruxism) can be a physical signal of airway obstruction or sleep-disordered breathing.