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Evidence that Experimentally Induced Sleep Bruxism is a Consequence of Transient Arousal

¹ Centre d’étude sur le Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal;
² Facultés de médecine et de médecine dentaire, Université de Montréal, CP6128, succursale Centre-ville, Montréal, H3C 3J7, Québec, Canada;
³ Centre de recherche en sciences neurologiques, Université de Montréal;
⁴ Faculty of Dentistry, McGill University; and
⁵ Faculty of Dentistry, University of Toronto;

View larger version (29K): [in a new window]   Figure 1. Experimentally induced arousal and RMMA. (A) Percentage of stimuli that caused experimental arousal during sleep. No group difference was found for the frequency of experimental arousal (p > 0.05, ANOVA). St2, stage 2; St3&4, stages 3 and 4; and REM, rapid eye movement sleep. Open bars, normal subjects (n = 8); filled bars, SB patients (n = 8). L, M, and H: low, medium, and high intensity of stimuli. Data were presented as mean ± SEM. (B) An example of an RMMA episode induced by stimulus in an SB patient during sleep stage 2. Following VT+AD stimulation (arrow), the change in cortical EEG activity (C3A2, O2A1) was followed by repetitive phasic masseter (MAS) and suprahyoid (SH) EMG activity with grinding noise. EOG, electro-oculogram; TA, anterior tibialis muscle activity; EKG, electrocardiogram. Horizontal bar 3 sec; vertical bar, 100 µV. (C) The percentage of trials with RMMA episodes occurring during experimental arousal. All SB patients showed RMMA episodes during experimental arousal, while only one normal subject did. Filled circles, SB patients (n = 8); open circles, normal subjects (n = 8). ***p = 0.003; Mann-Whitney test.

View larger version (27K): [in a new window]   Figure 2. Changes in muscle tone and heart rate during experimental arousal for trials without RMMA. (A) An increase in EMG activity in suprahyoid (SH) and masseter (MAS) muscles for sleep stage 2 (St2) and rapid eye movement sleep (REM). No group difference was found (p > 0.05 for all, ANOVA). EMG was averaged for periods of -2 to 0 sec (-1), 0 to 2 (1), 2 to 4 (3), and 4 to 6 (5) after stimulus onset (time 0). (B) A heart rate increase reached its peak at four to five beats after the onset of the stimulus (arrowhead) and was then followed by a clear deceleration. No group difference was found (p > 0.05 for both stages, ANOVA). Filled circles, SB patients (n = 8); open circles, normal subjects (n = 8). Data were presented as mean ± SEM.