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Prevalence and predictors of sleep bruxism in patients with obstructive sleep apnea and the effect of positive airway pressure treatment

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
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Abstract

Background

Sleep bruxism (SB) is often found to co-exist with obstructive sleep apnea (OSA). However, there are no data on prevalence and risk factors of SB in patients with OSA patients regarding the effect of optimal positive airway pressure (PAP).

Objective

This study aimed to study prevalence and risk factors of SB in OSA and to compare SB episodes during pre-treatment versus during optimal PAP therapy.

Methods

This investigation was a retrospective study including randomly selected patients with OSA who underwent split-night polysomnography. Data were collected from August 2021 to October 2022. Clinical demographic data and SB data were analyzed. The association between SB episodes and obstructive respiratory events were manually reviewed. If most of the SB episodes were observed within 5 s following obstructive respiratory events, SB was defined as SB associated with OSA. Comparison of SB index (SBI) was made between baseline portion of the study versus during optimal PAP.

Results

Among 100 patients enrolled, mean age was 50.8 ± 16.7 years and 73 subject (73%) were male. Mean respiratory disturbance index (RDI) and mean nadir oxygen saturation were 52.4 ± 33.4 and 79.3 ± 11.2% respectively. During the baseline portion of the study, 49 patients (49%) had SB and 31 patients (31%) had severe SB (SBI ≥ 4). Sleep bruxism associated with OSA was observed in 73.5% of all SB. The risk factor for SB was endorsement of nocturnal tooth grinding (odds ratio (OR) 5.69, 95%CI 1.74–18.58). Risk factors for severe bruxism were male sex (OR 4.01, 95%CI 1.02–15.88) and endorsement of nocturnal tooth grinding (OR 9.63, 95%CI 2.54–36.42). Risk factors for SB associated with OSA were non-supine RDI (OR 1.02, 95%CI 1.001–1.034) and endorsement of nocturnal tooth grinding (OR 5.4, 95%CI 1.22–23.93). In SB group, when comparison was made between baseline portion and during optimal PAP, significant reduction of SBI was observed (5.5 (3.2, 9.3) vs. 0 (0, 2.1), p < 0.001). Median difference of SBI between baseline portion and during optimal PAP was 4.4 (2.0, 8.3) (p < 0.001).

Conclusions

In this group of patients with OSA, almost half was observed to have SB in which the majority were associated with OSA. Optimal PAP resulted in a significant reduction in SB episodes. In addition to endorsement of nocturnal tooth grinding, non-supine RDI was observed to be a potential risk factor for SB associated with OSA.

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Authors and Affiliations

  1. Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

    Nattapot Dadphan, Dittapol Muntham & Naricha Chirakalwasan

  2. Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Nattapot Dadphan & Naricha Chirakalwasan

  3. Dental Sleep Medicine Clinic, Dental Hospital and Department of Oral Diagnostic Science, Faculty of Dentistry, Prince of Songkla University, Hat-Yai, Songkhla, Thailand

    Premthip Chalidapongse

  4. Section for Mathematics, Faculty of Science and Technology, Rajamangala University of Technology Suvarnabhumi, Phranakhon Si Ayutthaya, Thailand

    Dittapol Muntham

  5. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Naricha Chirakalwasan

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  1. Nattapot Dadphan
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Correspondence to Naricha Chirakalwasan.

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Dadphan, N., Chalidapongse, P., Muntham, D. et al. Prevalence and predictors of sleep bruxism in patients with obstructive sleep apnea and the effect of positive airway pressure treatment. Sleep Breath (2024). https://doi.org/10.1007/s11325-023-02985-z

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  • DOI: https://doi.org/10.1007/s11325-023-02985-z

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