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Published in: Sleep and Breathing 5/2023

Open Access 03-03-2023 | Sleep Apnea | Sleep Breathing Physiology and Disorders • Original Article

Effects of continuous positive airway pressure and mandibular advancement appliance therapy on sleep bruxism in adults with obstructive sleep apnea: a pilot study

Authors: Deshui Li, Frank Lobbezoo, Boyuan Kuang, Antonius A. J. Hilgevoord, Nico de Vries, Ghizlane Aarab

Published in: Sleep and Breathing | Issue 5/2023

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Abstract

Study objectives

This study aimed to investigate the effects of continuous positive airway pressure (CPAP) and mandibular advancement appliance (MAA) therapy on rhythmic masticatory muscle activity (RMMA), a biomarker of sleep bruxism (SB), and to compare the effects of CPAP with MAA in adults with obstructive sleep apnea (OSA).

Methods

This cohort study included individuals with OSA who received treatment with CPAP or MAA. Polysomnographic recordings with and without therapy were performed in each individual. Statistical analyses were performed with repeated measures ANOVA.

Results

A total of 38 individuals with OSA were enrolled, 13 on CPAP and 25 with MAA, mean age 52.6 ± 10.6 years, 32 men, mean baseline apnea-hypopnea index (AHI) 26.5 ± 15.2 events/hour, mean RMMA index 3.5 ±events/hour. In the total group, the RMMA index decreased significantly with CPAP and MAA therapies (P < 0.05). The changes in the RMMA index with therapy did not differ significantly between CPAP and MAA (P > 0.05). The RMMA index decreased in 60% of the individuals with OSA, and the changes ranged widely, with a median of 52% and an interquartile range of 107%.

Conclusions

Both CPAP and MAA therapies significantly reduce SB in individuals with OSA. However, the interindividual differences in the effects of these therapies on SB are large.
Clinical Trial Registration: https://​trialsearch.​who.​int (NL8516); April 08, 2020
Literature
1.
2.
go back to reference Shah N, Roux F (2009) The relationship of obesity and obstructive sleep apnea. Clin Chest Med 30:455–465CrossRefPubMed Shah N, Roux F (2009) The relationship of obesity and obstructive sleep apnea. Clin Chest Med 30:455–465CrossRefPubMed
3.
go back to reference Senaratna CV, Perret JL, Lodge CJ et al (2017) Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev 34:70–81CrossRefPubMed Senaratna CV, Perret JL, Lodge CJ et al (2017) Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev 34:70–81CrossRefPubMed
4.
go back to reference Somers VK, White DP, Amin R et al (2008) Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation scientific statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on. Circulation 118:1080–1111CrossRefPubMed Somers VK, White DP, Amin R et al (2008) Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation scientific statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on. Circulation 118:1080–1111CrossRefPubMed
5.
go back to reference Tasali E, Ip MSM (2008) Obstructive sleep apnea and metabolic syndrome: Alterations in glucose metabolism and inflammation. Proc Am Thorac Soc 5:207–217CrossRefPubMed Tasali E, Ip MSM (2008) Obstructive sleep apnea and metabolic syndrome: Alterations in glucose metabolism and inflammation. Proc Am Thorac Soc 5:207–217CrossRefPubMed
7.
go back to reference Lobbezoo F, Ahlberg J, Raphael KG et al (2018) International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil 45:837–844CrossRefPubMedPubMedCentral Lobbezoo F, Ahlberg J, Raphael KG et al (2018) International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil 45:837–844CrossRefPubMedPubMedCentral
8.
go back to reference Ohayon MM, Li KK, Guilleminault C (2001) Risk factors for sleep bruxism in the general population. Chest 119:53–61CrossRefPubMed Ohayon MM, Li KK, Guilleminault C (2001) Risk factors for sleep bruxism in the general population. Chest 119:53–61CrossRefPubMed
9.
go back to reference Martynowicz H, Gac P, Brzecka A et al (2019) The relationship between sleep bruxism and obstructive sleep apnea based on polysomnographic findings. J Clin Med 8:1653CrossRefPubMedPubMedCentral Martynowicz H, Gac P, Brzecka A et al (2019) The relationship between sleep bruxism and obstructive sleep apnea based on polysomnographic findings. J Clin Med 8:1653CrossRefPubMedPubMedCentral
10.
go back to reference Kuang B, Li D, Lobbezoo F et al (2022) Associations between sleep bruxism and other sleep-related disorders in adults: a systematic review. Sleep Med 89:31–47CrossRefPubMed Kuang B, Li D, Lobbezoo F et al (2022) Associations between sleep bruxism and other sleep-related disorders in adults: a systematic review. Sleep Med 89:31–47CrossRefPubMed
11.
go back to reference Oksenberg A, Arons E (2002) Sleep bruxism related to obstructive sleep apnea: The effect of continuous positive airway pressure. Sleep Med 3:513–515CrossRefPubMed Oksenberg A, Arons E (2002) Sleep bruxism related to obstructive sleep apnea: The effect of continuous positive airway pressure. Sleep Med 3:513–515CrossRefPubMed
12.
go back to reference Martinot JB, Borel JC, Le-Dong NN et al (2020) Bruxism relieved under CPAP treatment in a patient with OSA syndrome. Chest 157:e59–e62CrossRefPubMed Martinot JB, Borel JC, Le-Dong NN et al (2020) Bruxism relieved under CPAP treatment in a patient with OSA syndrome. Chest 157:e59–e62CrossRefPubMed
13.
go back to reference Landry-Schönbeck A, de Grandmont P, Rompré PH, Lavigne GJ (2010) Effect of an adjustable mandibular advancement appliance on sleep bruxism: a crossover sleep laboratory study. Int J Prosthodont 22(3):251–259 Landry-Schönbeck A, de Grandmont P, Rompré PH, Lavigne GJ (2010) Effect of an adjustable mandibular advancement appliance on sleep bruxism: a crossover sleep laboratory study. Int J Prosthodont 22(3):251–259
14.
go back to reference Solanki N, Singh BP, Chand P et al (2017) Effect of mandibular advancement device on sleep bruxism score and sleep quality. J Prosthet Dent 117:67–72CrossRefPubMed Solanki N, Singh BP, Chand P et al (2017) Effect of mandibular advancement device on sleep bruxism score and sleep quality. J Prosthet Dent 117:67–72CrossRefPubMed
15.
go back to reference Okeson JP, Phillips BA, Berry DT et al (1991) Nocturnal bruxing events in subjects with sleep-disordered breathing and control subjects. J Craniomandib Disord 5:258–264PubMed Okeson JP, Phillips BA, Berry DT et al (1991) Nocturnal bruxing events in subjects with sleep-disordered breathing and control subjects. J Craniomandib Disord 5:258–264PubMed
16.
go back to reference Sjöholm TT, Lowe AA, Miyamoto K et al (2000) Sleep bruxism in patients with sleep-disordered breathing. Arch Oral Biol 45:889–896CrossRefPubMed Sjöholm TT, Lowe AA, Miyamoto K et al (2000) Sleep bruxism in patients with sleep-disordered breathing. Arch Oral Biol 45:889–896CrossRefPubMed
17.
go back to reference Li D, Aarab G, Lobbezoo F et al (2022) Accuracy of sleep bruxism scoring based on electromyography traces of different jaw muscles in individuals with obstructive sleep apnea. J Clin Sleep Med 18:1609–1615CrossRefPubMedPubMedCentral Li D, Aarab G, Lobbezoo F et al (2022) Accuracy of sleep bruxism scoring based on electromyography traces of different jaw muscles in individuals with obstructive sleep apnea. J Clin Sleep Med 18:1609–1615CrossRefPubMedPubMedCentral
18.
go back to reference Berry RB, Brooks R, Gamaldo CE et al (2017) The AASM Manual for the Scoring of Sleep and Associated Events, ver 2.6. American Academy of Sleep Medicine, Darien Berry RB, Brooks R, Gamaldo CE et al (2017) The AASM Manual for the Scoring of Sleep and Associated Events, ver 2.6. American Academy of Sleep Medicine, Darien
19.
go back to reference Li D, Aarab G, Lobbezoo F et al (2022) The effects of mandibular advancement appliance therapy on the sequence of jaw-closing muscle activity and respiratory events in individuals with obstructive sleep apnea. Sleep Breath 109:1545–1553 Li D, Aarab G, Lobbezoo F et al (2022) The effects of mandibular advancement appliance therapy on the sequence of jaw-closing muscle activity and respiratory events in individuals with obstructive sleep apnea. Sleep Breath 109:1545–1553
20.
go back to reference Aarab G, Arcache P, Lavigne GJ et al (2020) The effects of mandibular advancement appliance therapy on jaw-closing muscle activity during sleep in patients with obstructive sleep apnea: A 3–6 months follow-up. J Clin Sleep Med 16:1545–1553CrossRefPubMedPubMedCentral Aarab G, Arcache P, Lavigne GJ et al (2020) The effects of mandibular advancement appliance therapy on jaw-closing muscle activity during sleep in patients with obstructive sleep apnea: A 3–6 months follow-up. J Clin Sleep Med 16:1545–1553CrossRefPubMedPubMedCentral
21.
go back to reference Landry M-L, Rompré PH, Manzini C et al (2010) Reduction of sleep bruxism using a mandibular advancement device: an experimental controlled study. Int J Prosthodont 19(6):549–556 Landry M-L, Rompré PH, Manzini C et al (2010) Reduction of sleep bruxism using a mandibular advancement device: an experimental controlled study. Int J Prosthodont 19(6):549–556
22.
go back to reference Balasubramaniam R, Paesani D, Koyano K et al (2017) Sleep bruxism. In: Farah C, Balasubramaniam R, MacCullough MJ (eds) Contemporary oral medicine. Springer, Cham Balasubramaniam R, Paesani D, Koyano K et al (2017) Sleep bruxism. In: Farah C, Balasubramaniam R, MacCullough MJ (eds) Contemporary oral medicine. Springer, Cham
23.
go back to reference Doff MHJ, Hoekema A, Wijkstra PJ et al (2013) Oral Appliance versus continuous positive airway pressure in obstructive sleep apnea syndrome: A 2-year follow-up. Sleep 36:1289–1296CrossRefPubMedPubMedCentral Doff MHJ, Hoekema A, Wijkstra PJ et al (2013) Oral Appliance versus continuous positive airway pressure in obstructive sleep apnea syndrome: A 2-year follow-up. Sleep 36:1289–1296CrossRefPubMedPubMedCentral
24.
go back to reference Aarab G, Lobbezoo F, Hamburger HL, Naeije M (2011) Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: A randomized, placebo-controlled trial. Respiration 81:411–419CrossRefPubMed Aarab G, Lobbezoo F, Hamburger HL, Naeije M (2011) Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: A randomized, placebo-controlled trial. Respiration 81:411–419CrossRefPubMed
26.
go back to reference Lavigne GJ, Huynh N, Kato T et al (2007) Genesis of sleep bruxism: Motor and autonomic-cardiac interactions. Arch Oral Biol 52:381–384CrossRefPubMed Lavigne GJ, Huynh N, Kato T et al (2007) Genesis of sleep bruxism: Motor and autonomic-cardiac interactions. Arch Oral Biol 52:381–384CrossRefPubMed
27.
go back to reference Manfredini D, Ahlberg J, Winocur E, Lobbezoo F (2015) Management of sleep bruxism in adults: A qualitative systematic literature review. J Oral Rehabil 42:862–874CrossRefPubMed Manfredini D, Ahlberg J, Winocur E, Lobbezoo F (2015) Management of sleep bruxism in adults: A qualitative systematic literature review. J Oral Rehabil 42:862–874CrossRefPubMed
28.
go back to reference van der Zaag J, Lobbezoo F, Wicks DJ et al (2005) Controlled assessment of the efficacy of occlusal stabilization splints on sleep bruxism. J Orofac Pain 19:151–158PubMed van der Zaag J, Lobbezoo F, Wicks DJ et al (2005) Controlled assessment of the efficacy of occlusal stabilization splints on sleep bruxism. J Orofac Pain 19:151–158PubMed
29.
go back to reference Van Der Zaag J, Lobbezoo F, Visscher CM et al (2008) Time-variant nature of sleep bruxism outcome variables using ambulatory polysomnography: implications for recognition and therapy evaluation. J Oral Rehabil 35:577–584CrossRefPubMed Van Der Zaag J, Lobbezoo F, Visscher CM et al (2008) Time-variant nature of sleep bruxism outcome variables using ambulatory polysomnography: implications for recognition and therapy evaluation. J Oral Rehabil 35:577–584CrossRefPubMed
30.
go back to reference Valdés C, Astaburuaga F, Falace D et al (2014) Effect of tongue position on masseter and temporalis electromyographic activity during swallowing and maximal voluntary clenching: A cross-sectional study. J Oral Rehabil 41:881–889CrossRefPubMed Valdés C, Astaburuaga F, Falace D et al (2014) Effect of tongue position on masseter and temporalis electromyographic activity during swallowing and maximal voluntary clenching: A cross-sectional study. J Oral Rehabil 41:881–889CrossRefPubMed
Metadata
Title
Effects of continuous positive airway pressure and mandibular advancement appliance therapy on sleep bruxism in adults with obstructive sleep apnea: a pilot study
Authors
Deshui Li
Frank Lobbezoo
Boyuan Kuang
Antonius A. J. Hilgevoord
Nico de Vries
Ghizlane Aarab
Publication date
03-03-2023
Publisher
Springer International Publishing
Published in
Sleep and Breathing / Issue 5/2023
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-023-02799-z

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