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Theories on possible temporal relationships between sleep bruxism and obstructive sleep apnea events. An expert opinion

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Abstract

Background

Sleep bruxism (SB) is a term covering different motor phenomena with various risk and etiological factors and potentially different clinical relevance, especially as far as its possible protective role against obstructive sleep apnea (OSA) is concerned. The present expert opinion discusses the possible temporal relationships between the two phenomena.

Methods

Four hypothetical scenarios for a temporal relationship may be identified: (1) the two phenomena are unrelated; (2) the onset of the OSA event precedes the onset of the SB event within a limited time span, with SB having a potential OSA-protective role; (3) the onset of the SB event precedes the onset of the OSA event within a limited time span, with SB having an OSA-inducing effect; and (4) the onset of the OSA and SB event occurs at the same moment.

Results

Literature findings on the SB-OSA temporal relationship are inconclusive. The most plausible hypothesis is that the above scenarios are all actually possible and that the relative predominance of one specific sequence of events varies at the individual level. SB activity may be protective against OSA by protruding the mandible and restoring airway patency in those subjects who benefit from mandibular advancement strategies or may even be related to OSA induction, as a consequence of airways’ mucosae swelling resulting from a SB-induced trigeminal cardiac reflex.

Conclusions

Clinicians should keep in mind that the SB-OSA relationship is complex and that interindividual differences may explain the possible different SB-OSA relationships, with particular regard to the anatomical site of obstruction.

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Financial support

The authors declare they did not receive any financial support for this investigation.

Conflict of interest

The authors declare they did not have any conflicts of interest related with this manuscript.

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Authors and Affiliations

  1. Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy

    Daniele Manfredini & Luca Guarda-Nardini

  2. Institute of Otolaryngology, Department of Neurosciences, University of Padova, Padova, Italy

    Rosario Marchese-Ragona

  3. Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands

    Frank Lobbezoo

Authors
  1. Daniele Manfredini
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  2. Luca Guarda-Nardini
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  3. Rosario Marchese-Ragona
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  4. Frank Lobbezoo
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Corresponding author

Correspondence to Daniele Manfredini.

Additional information

Daniele Manfredini holds DDS, PhD, University of Padova.

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Manfredini, D., Guarda-Nardini, L., Marchese-Ragona, R. et al. Theories on possible temporal relationships between sleep bruxism and obstructive sleep apnea events. An expert opinion. Sleep Breath 19, 1459–1465 (2015). https://doi.org/10.1007/s11325-015-1163-5

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  • DOI: https://doi.org/10.1007/s11325-015-1163-5

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