Identifying Predictive Factors for Sleep Bruxism Severity Using Clinical and Polysomnographic Parameters: a Principal Component Analysis

Overview

Journal J Clin Sleep Med

Specialties Neurology
Psychiatry

Date 2021 Jan 12

PMID 33432920

Citations 1

Authors

Joao Vicente Rosar

Maria Carolina Salome Marquezin

Aianne Souto Pizzolato

Fernanda Yukie Kobayashi

Sandra Kalil Bussadori

Luciano Jose Pereira

Paula Midori Castelo

Affiliations

Soon will be listed here.

Abstract

Study Objectives: The aim was to identify predictive factors for sleep bruxism (SB) severity among polysomnographic parameters, salivary cortisol levels, temporomandibular disorders, age, and sex.

Methods: Young adults (19-30 years) were screened for self-/roommate reports of teeth grinding/clenching during sleep associated with clinical signs of tooth wear. Individuals positive for both conditions were administered a polysomnographic exam to provide a definite diagnosis of SB (n = 28). Healthy participants without SB signs/symptoms were also included (n = 15). The Research Diagnostic Criteria for Temporomandibular Disorders was applied to determine functional, muscular, and articular domains of the Temporomandibular Index. Cortisol awakening levels were measured in saliva. Principal component analysis was used to extract the latent components emerging from polysomnographic results, and 2 regression models were adjusted to predict the number and duration of bruxism episodes.

Results: Principal component analysis resulted in 4 components-C1: %N1, total sleep time, sleep efficiency, arousals/microarousals; C2: %N2, %N3; C3: periodic limb movements and apneas; C4: %REM and REM latency. The number of SB episodes/h was predicted by increasing muscular scores and C2 (decrease in %N2 and increase in %N3) (adjusted R² = 45%; P =.001). The total time of SB episodes was predicted by decreased articular and increased functional scores, age, and female sex (adjusted R² = 36%; P = 0.010). Salivary cortisol levels were not associated with SB severity and did not differ between groups.

Conclusions: The findings showed that SB severity was predicted by muscular and functional scores, female sex, and distinct polysomnographic patterns, contributing to the deeper knowledge of the underlying pathophysiology of SB severity; additionally, the findings can help to formulate health approaches that are specific to the patient and will better assist in treating this condition.

Citing Articles

Is There a Relationship between Salivary Cortisol and Temporomandibular Disorder: A Systematic Review.

AlSahman L, AlBagieh H, AlSahman R Diagnostics (Basel). 2024; 14(13).

PMID: 39001325 PMC: 11241310. DOI: 10.3390/diagnostics14131435.

References

Castelo P, Barbosa T, Pereira L, Fonseca F, Gaviao M . Awakening salivary cortisol levels of children with sleep bruxism. Clin Biochem. 2012; 45(9):651-4. DOI: 10.1016/j.clinbiochem.2012.03.013. View

Rosar J, Barbosa T, Dias I, Kobayashi F, Costa Y, Gaviao M . Effect of interocclusal appliance on bite force, sleep quality, salivary cortisol levels and signs and symptoms of temporomandibular dysfunction in adults with sleep bruxism. Arch Oral Biol. 2017; 82:62-70. DOI: 10.1016/j.archoralbio.2017.05.018. View

Lobbezoo F, Ahlberg J, Raphael K, Wetselaar P, Glaros A, Kato T . International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil. 2018; 45(11):837-844. PMC: 6287494. DOI: 10.1111/joor.12663. View

Grigg-Damberger M . The AASM scoring manual: a critical appraisal. Curr Opin Pulm Med. 2009; 15(6):540-9. DOI: 10.1097/MCP.0b013e328331a2bf. View

Raphael K, Janal M, Sirois D, Dubrovsky B, Klausner J, Krieger A . Validity of self-reported sleep bruxism among myofascial temporomandibular disorder patients and controls. J Oral Rehabil. 2015; 42(10):751-8. PMC: 4573343. DOI: 10.1111/joor.12310. View

Blanco Aguilera A, Lopez L, Blanco Aguilera E, de la Hoz Aizpurua J, Rodriguez Torronteras A, Segura Saint-Gerons R . Relationship between self-reported sleep bruxism and pain in patients with temporomandibular disorders. J Oral Rehabil. 2014; 41(8):564-72. DOI: 10.1111/joor.12172. View

Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet J . Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache. 2014; 28(1):6-27. PMC: 4478082. DOI: 10.11607/jop.1151. View

Meeusen R, Duclos M, Foster C, Fry A, Gleeson M, Nieman D . Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med Sci Sports Exerc. 2012; 45(1):186-205. DOI: 10.1249/MSS.0b013e318279a10a. View

Kishi A, Haraki S, Toyota R, Shiraishi Y, Kamimura M, Taniike M . Sleep stage dynamics in young patients with sleep bruxism. Sleep. 2019; 43(1). DOI: 10.1093/sleep/zsz202. View

10.

Pehling J, Schiffman E, Look J, Shaefer J, Lenton P, Fricton J . Interexaminer reliability and clinical validity of the temporomandibular index: a new outcome measure for temporomandibular disorders. J Orofac Pain. 2002; 16(4):296-304. View

11.

Gungormus Z, Erciyas K . Evaluation of the relationship between anxiety and depression and bruxism. J Int Med Res. 2009; 37(2):547-50. DOI: 10.1177/147323000903700231. View

12.

Baad-Hansen L, Thymi M, Lobbezoo F, Svensson P . To what extent is bruxism associated with musculoskeletal signs and symptoms? A systematic review. J Oral Rehabil. 2019; 46(9):845-861. DOI: 10.1111/joor.12821. View

13.

Lavigne G, Rompre P, Montplaisir J . Sleep bruxism: validity of clinical research diagnostic criteria in a controlled polysomnographic study. J Dent Res. 1996; 75(1):546-52. DOI: 10.1177/00220345960750010601. View

14.

Wetselaar P, Vermaire E, Lobbezoo F, Schuller A . The prevalence of awake bruxism and sleep bruxism in the Dutch adult population. J Oral Rehabil. 2019; 46(7):617-623. PMC: 6849828. DOI: 10.1111/joor.12787. View

15.

Raphael K, Santiago V, Lobbezoo F . Is bruxism a disorder or a behaviour? Rethinking the international consensus on defining and grading of bruxism. J Oral Rehabil. 2016; 43(10):791-8. PMC: 5538376. DOI: 10.1111/joor.12413. View

16.

Refulio Z, Rocafuerte M, De La Rosa M, Mendoza G, Chambrone L . Association among stress, salivary cortisol levels, and chronic periodontitis. J Periodontal Implant Sci. 2013; 43(2):96-100. PMC: 3651943. DOI: 10.5051/jpis.2013.43.2.96. View

17.

Vieira K, Folchini C, Heyde M, Stuginski-Barbosa J, Kowacs P, Piovesan E . Wake-Up Headache Is Associated With Sleep Bruxism. Headache. 2020; 60(5):974-980. DOI: 10.1111/head.13816. View

18.

Kobayashi F, Gaviao M, Marquezin M, Fonseca F, Montes A, Barbosa T . Salivary stress biomarkers and anxiety symptoms in children with and without temporomandibular disorders. Braz Oral Res. 2017; 31:e78. DOI: 10.1590/1807-3107BOR-2017.vol31.0078. View

19.

Lavigne G, Kato T, Kolta A, Sessle B . Neurobiological mechanisms involved in sleep bruxism. Crit Rev Oral Biol Med. 2003; 14(1):30-46. DOI: 10.1177/154411130301400104. View

20.

Huhtela O, Napankangas R, Joensuu T, Raustia A, Kunttu K, Sipila K . Self-Reported Bruxism and Symptoms of Temporomandibular Disorders in Finnish University Students. J Oral Facial Pain Headache. 2016; 30(4):311-317. DOI: 10.11607/ofph.1674. View