Predicting and assessing the impacts of risk factors for sleep bruxism in an apneic population using a nomogram

This cross-sectional study aimed to develop a tool to predict sleep bruxism (SB) and estimate the impacts of risk factors found for SB in a personalized manner for each apneic patient.

A total of 321 individuals with apnea underwent full-night type 1 polysomnography. SB was assessed using electrodes applied to the masseter and chin muscles. Data collected included the apnea and hypopnea index, sleep arousal index, total sleep time, sex, and commonly used medications. SB was defined as experiencing more than two rhythmic masticatory muscle activity events per hour of sleep. Statistical analysis identified variables associated with SB, leading to the creation of a nomogram.

Risk factors for SB in this population included the non-use of thyroid medications, the use of antidepressants, male sex, sleep arousals, total sleep time, and the apnea-hypopnea index. The nomogram enables prediction of SB and assessment of individualized impacts of SB risk factors for each patient.

When SB treatment is required in apneic individuals, fill in the nomogram allows for the assessment of important SB risk factors impacts and the targeting of personalized intervention strategies. SB interventions should involve a multidisciplinary team due to potential connections with systemic disorders. Future studies with longitudinal designs or RCT are essential to validate the nomogram. Statement of Significance When addressing the treatment of sleep bruxism in individuals with apnea, approaches should consider the impacts of some important related risk factors, identified through the individualized use of the nomogram-a novel tool developed by this research group. Additionally, when sleep bruxism is present, it's crucial to screen for associated conditions such as untreated thyroid disorders, obstructive sleep apnea, issues leading to the use of antidepressant medication, and frequent sleep disturbances. Dentists play an essential role in diagnosing potential systemic issues, contributing significantly by identifying signs and symptoms that manifest in the orofacial region.