ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title In Patients with Obstructive Sleep Apnea (OSA), There is a Greater Prevalence of Sleep Bruxism When Compared to Those Without Obstructive Sleep Apnea
Clinical Question In patients with sleep bruxism, is there a greater prevalence of OSA when compared to those without sleep bruxism?
Clinical Bottom Line In patients with obstructive sleep apnea, there is a greater prevalence of sleep bruxism when compared to those without obstructive sleep apnea.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 11157584Ohayon/200113057 subjects aged > or = 15 yearsSurvey
Key resultsIn the control group with no tooth grinding, 1.4% exhibited obstructive sleep apnea. However, in the group of patients diagnosed with sleep bruxism, that number rose to 4.8%, producing a p value of < 0.0001. This displays a > 95% confidence in the presence of obstructive sleep apnea being a significant factor in producing higher prevalence of sleep bruxism.
#2) 24526386Hosoya/201467 patients with obstructive sleep apnea syndrome in whom sleep apnea occurred 5 or more times per hourCase Control Study
Key resultsThe prevalence of sleep bruxism was higher in the patients with obstructive sleep apnea syndrome than it was in the control group. 47.8% of the obstructive sleep apnea syndrome patients were diagnosed with sleep bruxism. The frequency of sleep bruxism was significantly higher with an occurrence of 7.02 events per hour with a standard deviation of 10.1 while the control group exhibits 2.88 event per hour with a 1.47 standard deviation (p<0.05).
Evidence Search ("Sleep Bruxism"[Mesh]) AND "Sleep Apnea, Obstructive"[Mesh]
Comments on
The Evidence
Validity: Groups were randomly selected but not randomly allocated. They were similar at start with the same tests and environment being tested in. More than 80% of the patients completed the study. Groups were treated the same. Adequate follow-up and compliance were present to gather accurate results. However, the study double-blind and recall bias do not apply to this study type. The study was supported by the Fond de la Recherche en Sante du Quebec and by an educational grant from Synthelabo Group. However, the article does not give an indication of whether or not conflicting interests are present. Perspective: Though the study was a survey, which does not usually provide high level of evidence, the validity of the study is still kept at a relatively high level with the extremely large sample size utilized. Validity: For the case control study, groups were similar at start with the same tests and environment being tested in. More than 80% of the patients completed the study. Groups were treated the same. Adequate follow-up and compliance were present to gather accurate results. However, it was not apparent the study was double blinded or whether or not the recall bias was unlikely. There was no competing interest to declare. Perspective: Though, case control study is not the most reliable of studies, this study seems relatively valid as most validity guidelines were followed.
Applicability The patients are all in good medical health/dental health as of right now. But, without treating the sleep apnea, bruxism could potentially cause many dental complications. The association between obstructive sleep apnea and sleep bruxism may motivate the patients to find a treatment plan, whether surgically or with a positive air pressure device, for the sleep apnea and resolve both problems at the same time.
Specialty/Discipline (General Dentistry)
Keywords Obstructive sleep apnea, sleep bruxism
ID# 2856
Date of submission: 04/15/2015spacer
E-mail hohr@livemail.uthscsa.edu
Author Ryan Ho
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Kevin M. Gureckis, DMD
Faculty mentor/Co-author e-mail gureckis@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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