The effects of nocturnal electromyographic biofeedback on sleep quality and psychological stress

Abstract

Background

Sleep bruxism (SB) causes many dental problems and complications with fixed partial dentures on implants. Although it is an important issue in clinical dentistry, no reliable treatment is available for SB. In the present study, we employed the electromyographic biofeedback device SleepGuardTM, which is attached to the forehead, detects SB, and alerts subjects with a gentle beeping sound to stop SB. The aim of the present study was to clarify the effects of biofeedback treatment on the incidence of masticatory muscle activity, sleep quality, and psychological stress levels.

Materials and methods

Ten subjects (five male and five female subjects) participated in the study, and a crossover design was used. Sleep measurements were taken on three consecutive nights to obtain data without SleepGuardTM (baseline group), with SleepGuardTM with the beeping sound (on group), and with SleepGuardTM without the beeping sound (off group). Data obtained on the final day were evaluated. STAI-JYZ scores were assessed and salivary chromogranin A (CgA) levels and cortisol concentrations were measured to compare psychological and physical stress after sleep. Friedman’s and Dunn’s tests were used to compare each parameter among the three groups.

Results

A marked decrease was observed in the incidence of SB events per hour in seven subjects in the on group. The beeping of SleepGuardTM did not affect the percentage of sleep stages, salivary CgA levels, cortisol concentrations, or STAI-JYZ scores.

Conclusion

Our results suggest that biofeedback therapy with a beeping sound inhibited SB without negatively impacting sleep quality or psychological stress.

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References

  1. 1

    AASM. The International Classification of Sleep Disorders, 2nd edition: diagnostic and coding manual. Westchester: American Academy of Sleep Medicine; 2005.

    Google Scholar 

  2. 2

    Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ, et al. Bruxism defined and graded: an international consensus. J Oral Rehabil. 2013;40:2–4.

    CAS  Article  PubMed  Google Scholar 

  3. 3

    Carlsson GE. Critical review of some dogmas in prosthodontics. J Prosthodont Res. 2009;53:3–10.

    Article  PubMed  Google Scholar 

  4. 4

    McGuire MK, Nunn ME. Prognosis versus actual outcome. III. The effectiveness of clinical parameters in accurately predicting tooth survival. J Periodontol. 1996;67:666–74.

    CAS  Article  PubMed  Google Scholar 

  5. 5

    Ratcliff S, Becker IM, Quinn L. Type and incidence of cracks in posterior teeth. J Prosthet Dent. 2001;86:168–72.

    CAS  Article  PubMed  Google Scholar 

  6. 6

    Ekfeldt A, Christiansson U, Eriksson T, LindÈn U, Lundqvist S, Rundcrantz T, et al. A retrospective analysis of factors associated with multiple implant failures in maxillae. Clin Oral Implant Res. 2001;12:462–7.

    CAS  Article  Google Scholar 

  7. 7

    Brägger U, Aeschlimann S, Bergin W, Hoommerle CH, Lang NP. Biological and technical complications and failures with fixed partial dentures (FPD) on implants and teeth after four to five years of function. Clin Oral Implant Res. 2001;12:26–34.

    Article  Google Scholar 

  8. 8

    DubÈ C, RomprÈ PH, Manzini C, Guitard F, de Grandmont P, Lavigne GJ. Quantitative polygraphic controlled study on efficacy and safety of oral splint devices in tooth-grinding subjects. J Dent Res. 2004;83:398–403.

    Article  PubMed  Google Scholar 

  9. 9

    Harada T, Ichiki R, Tsukiyama Y, Koyano K. The effect of oral splint devices on sleep bruxism: a 6-week observation with an ambulatory electromyographic recording device. J Oral Rehabil. 2006;33:482–8.

    CAS  Article  PubMed  Google Scholar 

  10. 10

    Saletu A, Parapatics S, Saletu B, Anderer P, Prause W, Putz H, et al. On the pharmacotherapy of sleep bruxism: placebo-controlled polysomnographic and psychometric studies with clonazepam. Neuropsychobiology. 2005;51:214–25.

    CAS  Article  PubMed  Google Scholar 

  11. 11

    Huynh NT, Lavigne GJ, Lanfranchi PA, Montplaisir JY, de Champlain J. The effect of 2 sympatholytic medications—propranolol and clonidine—on sleep bruxism: experimental randomized controlled studies. Sleep. 2006;29:307–16.

    PubMed  Google Scholar 

  12. 12

    Huynh NT, Rompré PH, Montplaisir JY, Manzini C, Okura K, Lavigne GJ. Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size. Int J Prosthodont. 2006;19:435–41.

    PubMed  Google Scholar 

  13. 13

    Takahashi H, Masaki C, Makino M, Yoshida M, Mukaibo T, Kondo Y, et al. Management of sleep-time masticatory muscle activity using stabilisation splints affects psychological stress. J Oral Rehabil. 2013;40:892–9.

    CAS  Article  PubMed  Google Scholar 

  14. 14

    Winocur E, Gavish A, Voikovitch M, Emodi-Periman A, Eli I. Drugs and bruxism: a critical review. J Orofac Pain. 2003;17:99–111.

    PubMed  Google Scholar 

  15. 15

    Shim YJ, Lee MK, Kato T, Park HU, Heo K, Kim ST. Effects of botulinum toxin on jaw motor events during sleep in sleep bruxism patients: a polysomnographic evaluation. J Clin Sleep Med. 2014;10:291–8.

    PubMed Central  PubMed  Google Scholar 

  16. 16

    Jadidi F, Castrillon E, Svensson P. Effect of conditioning electrical stimuli on temporalis electromyographic activity during sleep. J Oral Rehabil. 2008;35:171–83.

    CAS  Article  PubMed  Google Scholar 

  17. 17

    Jadidi F, Castrillon E, Nielsen P, Baad-Hansen L, Svensson P. Effect of contingent electrical stimulation on jaw muscle activity during sleep: a pilot study with a randomized controlled trial design. Acta Odontol Scand. 2013;71:1050–62.

    Article  PubMed  Google Scholar 

  18. 18

    Sato M, Iizuka T, Watanabe A, Iwase N, Otsuka H, Terada N, et al. Electromyogram biofeedback training for daytime clenching and its effect on sleep bruxism. J Oral Rehabil. 2015;42:83–9.

    CAS  Article  PubMed  Google Scholar 

  19. 19

    Makino M, Masaki C, Tomoeda K, Kharouf E, Nakamoto T, Hosokawa R. The relationship between sleep bruxism behavior and salivary stress biomarker level. Int J Prosthodont. 2009;22:43–8.

    PubMed  Google Scholar 

  20. 20

    Tomoeda K, Makino M, Masaki C, Moritsuchi Y, Tsuda T, Nakamoto T, et al. Sleep bruxism needs deep sleep stages and seems to reduce psychological stress. Int J Stomatol Occlusion Med. 2011;4:54–8.

    Article  Google Scholar 

  21. 21

    Wang LF, Long H, Deng M, Xu H, Fang J, Fan Y, et al. Biofeedback treatment for sleep bruxism: a systematic review. Sleep Breath. 2014;18:235–42.

    Article  PubMed  Google Scholar 

  22. 22

    Ikeda T, Nishigawa K, Kondo K, Takeuchi H, Clark GT. Criteria for the detection of sleep-associated bruxism in humans. J Orofac Pain. 1996;10:270–82.

    CAS  PubMed  Google Scholar 

  23. 23

    Lavigne GJ, RomprÈ PH, Montplaisir JY. Sleep bruxism: validity of clinical research diagnostic criteria in a controlled polysomnographic study. J Dent Res. 1996;75:546–52.

    CAS  Article  PubMed  Google Scholar 

  24. 24

    Toda M, Den R, Nagasawa S, Kitamura K, Morimoto K. Relationship between lifestyle scores and salivary stress markers cortisol and chromogranin A. Arch Environ Occup Health. 2005;60:266–9

    CAS  Article  PubMed  Google Scholar 

  25. 25

    Nakane H, Asami O, Yamada Y, Harada T, Matsui N, Kanno T, et al. Salivary chromogranin a as an index of psychosomatic stress response. Biomed Res. 1998;19:401–6.

    CAS  Article  Google Scholar 

  26. 26

    Slavicek R, Sato S. [Bruxism-a function of the masticatory organ to cope with stress]. Wien Med Wochenschr. 2004;154:584–9.

    Article  PubMed  Google Scholar 

  27. 27

    Kato T, Thie NM, Huynh N, Miyawaki S, Lavigne GJ. Topical review: sleep bruxism and the role of peripheral sensory influences. J Orofac Pain. 2003;17:191–213.

    PubMed  Google Scholar 

  28. 28

    van der Zaag J, Lobbezoo F, Wicks DJ, Visscher CM, Hamburger HL, Naeije M. Controlled assessment of the efficacy of occlusal stabilization splints on sleep bruxism. J Orofac Pain. 2005;19:151–8.

    PubMed  Google Scholar 

  29. 29

    Bader GG, Kampe T, Tagdae T, Karlsson S, Blomqvist M. Descriptive physiological data on a sleep bruxism population. Sleep. 1997;20:982–90.

    CAS  PubMed  Google Scholar 

  30. 30

    Jadidi F, Nørregaard O, Baad-Hansen L, Arendt-Nielsen L, Svensson P. Assessment of sleep parameters during contingent electrical stimulation in subjects with jaw muscle activity during sleep: a polysomnographic study. Eur J Oral Sci. 2011;119:211–8.

    Article  PubMed  Google Scholar 

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Acknowledgments

This research was supported by a grant (24592926) for Science Research from the Ministry of Education, Science, and Culture, Tokyo, Japan. Masaki Yoshida is representative director of SleepWell, Osaka, Japan. Their contribution to this research included providing the portable one-channel EEG devices and technical support for the experiments.

Conflict of interest

S. Goto, C. Masaki, T. Mukaibo, H. Takahashi, Y. Kondo, T. Nakamoto, and R. Hosokawa state that there are no conflicts of interest.

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Correspondence to Chihiro Masaki PhD.

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Goto, S., Masaki, C., Mukaibo, T. et al. The effects of nocturnal electromyographic biofeedback on sleep quality and psychological stress. J. Stomat. Occ. Med. 8, 63–69 (2015). https://doi.org/10.1007/s12548-015-0131-9

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Keywords

  • Sleep bruxism
  • Biofeedback
  • Sleep quality
  • Psychological stress
  • Electromyogram