Bruxismo do sono e fatores associados: estudos envolvendo polissonografias

Abstract

Sleep Bruxism (SB) has been defined as a repetitive jaw-muscle activity characterized by clenching or teeth grinding and/or by bracing or even thrusting the mandible during sleep. The polysomnography (PSG) recording is the reference standard for definitive SB diagnosis. This dissertation was divided into two chapters. Chapter 1, a cross-sectional study evaluated the association between SB diagnosed by PSG and sociodemographic, occupational, clinical conditions, psychological, sleep quality variables. Chapter 2, a case-control study evaluated the association between SB diagnosed by PSG and sociodemographic, occupational, clinical conditions, sleep quality and sleep structure. In the first chapter, the findings showed that individuals with respiratory allergy (p=0.005) and respiratory disease (p=0.046) had higher prevalence of SB. Regarding sleep quality, the bivariate analysis showed statistically significant association between SB diagnosis and restless sleep (p=0.004), grinding teeth self-reported (p=0.003) and no obstructive sleep apnea (OSA) (p=0.024). In chapter 2, Individuals with SB presented higher proportion of overweight body mass index (BMI)(p=0.003), reported more alcohol consumption (p=0.018) and presented low OSA events (p=0.005) when compared to individuals without SB. Individuals in case group presented shorter wake time after sleep onset (WASO) (p= 0.002) and duration of non rapid eye movement (NREM) stage 1 (p=0.034); while the NREM stage 3 was longer compared to control group (p=0.001). Arousals (p=0.013), arousals per hour (p=0.009), respiratory disturbance index (RDI) (p=0.000), and AHI (apnoea-hypopnea index) (p=0.002) values were lower in case group. Thus, from the results obtained in this dissertation it was concluded that the SB was associated with clinical conditions (respiratory allergy and disease, BMI and alcohol consumption), sleep quality (restless sleep, grind teeth and ausence of OSA) and sleep structure (WASO, NREM stage 1 and 3, arousals and arousals per hour, RDI and AHI). Knowledge regarding factors associated with SB can contribute to decision making in the clinical setting and treatment strategies involving a multidisciplinar approach.