| Abstract | Cilj: Različiti poremećaji spavanja nerijetko se javljaju u iste osobe, stoga je cilj ovog istraživanja bio procijeniti učestalost noćnog bruksizma (engl. Sleep Bruxism, SB) u bolesnika s ranije dijagnosticiranom opstrukcijskom apnejom tijekom spavanja (engl. Obstructive Sleep Apnea, OSA) te razmotriti povezanost pojedinih stadija spavanja s pojavnosti epizoda SB-a.
Materijali i metode: U istraživanju je sudjelovalo ukupno 44 ispitanika s OSA-om, od čega je bilo 20 muškaraca i 24 žene raspoređenih u ispitivanu skupinu (22 ispitanika) i kontrolnu skupinu (22 ispitanika). Ispitanici su izabrani iz populacije bolesnika Centra za medicinu spavanja Medicinskog fakulteta Sveučilišta u Splitu i KBC-a Split kojima je provedena polisomnografija tijekom 2016. godine i utvrđena dijagnoza OSA-e. Ispitivanu skupinu činili su bolesnici koji su u upitniku o simptomima naveli kako noću škripe zubima, dok su kontrolnu skupinu činili bolesnici koji nisu navodili noćno škripanje zubima, a združeni su s bolesnicima iz ispitivane skupine po dobi (± 5 godina), spolu i AHI-ju. Stručno osoblje Centra za medicinu spavanja ponovno je analiziralo cjelonoćni polisomnografski zapis za sve ispitanike s obzirom na kriterije za SB.
Rezultati: Rezultati ovog istraživanja pokazali su znatno veću učestalost SB-a u bolesnika s OSA-om koji su sami prijavili kako noću škripe zubima, dok je u bolesnika koji nisu navodili noćno škripanje zubima učestalost SB bila nešto manja (95 % vs. 55 %, P = 0,02). Znatno više epizoda SB-a se dogodilo tijekom NREM stadija spavanja (84 %) nego li u REM stadiju (16 %), a najviše epizoda dogodilo se u N2 stadiju NREM spavanja, čak 77 % svih epizoda tijekom spavanja. Pokazano je kako postoji tendencija pojavljivanja duljih epizoda u NREM stadijima dok se one rjeđe javljaju u REM stadiju (42,4 ± 67,8 sekunda vs. 13,6 ± 19,0 sekunda , P = 0,024).
Zaključak: Temeljem rezultata ovog istraživanja utvrđeno je kako prisutnost OSA-e znatno povećava rizik za pojavu SB-a u istog bolesnika. SB se češće javlja u bolesnika s OSA-om koji su sami prijavili kako noću škripe zubima, ali nije zanemariva niti učestalost SB-a u onih koji to nisu prijavili. Stoga postoji potreba za korištenjem objektivne metode kao što je cjelonoćna polisomnografija za dijagnosticiranje SB-a, osobito u bolesnika s OSA-om. |
| Abstract (english) | Objective: Different sleep disorders often occur with the same individual, so the aim of this study was to estimate the incidence of sleep bruxism (Sleep Bruxism, SB) in patients with previously diagnosed obstructive sleep apnea (Obstructive Sleep Apnea, OSA) and to examine the relationship between sleep bruxism and sleep architecture.
Materials and methods: A total of 44 subjects with OSA participated in this study, 20 male and 24 female distributed in the study group (22 patients) and the control group (22 patients). The subjects were selected from the population of patients with previously diagnosed OSA who underwent polysomography in the Split Sleep Medicine Center at the University of Split during 2016. Patients who reported teeth grinding during sleep were recruited in the study group, while the control group consisted of patients who did not report teeth grinding during sleep and they were matched for age (± 5 years), gender and AHI. Full-night polysomnographic recordings were analyzed once again for all subjects according to SB criteria.
Results: The results of this study have shown significantly higher rate of SB in the population of patients with OSA who reported teeth grinding during sleep while the incidence of SB in the control subjects was smaller (95 % vs. 55 %, P = 0.02). There was higher incidence of SB episodes during the NREM sleep stage (84 %) than in REM sleep stage (16 %), while there was the highest incidence of SB episodes during the N2 sleep stage (77 %). Longer SB episodes showed tendency to appear more often during NREM than during REM sleep stages (42,4 ± 67,8 sekunda vs. 13,6 ± 19,0 sekunda, P = 0,024).
Conclusion: Based on the results of this study, it was determined that the presence of OSA significantly increased the risk of SB in the same patient. Incidence of SB was significantly higher in patients with OSA who reported teeth grinding during sleep than in those patients who did not, although in those patients the incidence of SB was still significantly high. Therefore, it is necessary to use objective methods such as full-night polysomnography for diagnosis of SB, especially in patients with OSA. |
