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1.
BMC Oral Health ; 24(1): 565, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38745301

RESUMO

BACKGROUND: The etiology of sleep bruxism in obstructive sleep apnea (OSA) patients is not yet fully clarified. This prospective clinical study aimed to investigate the connection between probable sleep bruxism, electromyographic muscle tone, and respiratory sleep patterns recorded during polysomnography. METHODS: 106 patients with OSA (74 males, 31 females, mean age: 56.1 ± 11.4 years) were divided into two groups (sleep bruxism: SB; no sleep bruxism: NSB). Probable SB were based on the AASM criteria: self-report of clenching/grinding, orofacial symptoms upon awakening, abnormal tooth wear and hypertrophy of the masseter muscle. Both groups underwent clinical examination for painful muscle symptoms aligned with Temporomandibular Disorders Diagnostic Criteria (DC/TMD), such as myalgia, myofascial pain, and headache attributed to temporomandibular disorder. Additionally, non-complaint positive muscle palpation and orofacial-related limitations (Jaw Functional Limited Scale-20: JFLS-20) were assessed. A one-night polysomnography with electromyographic masseter muscle tone (EMG) measurement was performed. Descriptive data, inter-group comparisons and multivariate logistic regression were calculated. RESULTS: OSA patients had a 37.1% prevalence of SB. EMG muscle tone (N1-N3, REM; P = 0.001) and the number of hypopneas (P = 0.042) were significantly higher in the sleep bruxism group. While measures like apnea-hypopnea-index (AHI), respiratory-disturbance-index (RDI), apnea index (AI), hypopnea-index (HI), number of arousals, and heart rate (1/min) were elevated in sleep bruxers, the differences were not statistically significant. There was no difference in sleep efficiency (SE; P = 0.403). Non-complaint masseter muscle palpation (61.5%; P = 0.015) and myalgia (41%; P = 0.010) were significant higher in SB patients. Multivariate logistic regression showed a significant contribution of EMG muscle tone and JFLS-20 to bruxism risk. CONCLUSION: Increased EMG muscle tone and orofacial limitations can predict sleep bruxism in OSA patients. Besides, SB patients suffer more from sleep disorder breathing. Thus, sleep bruxism seems to be not only an oral health related problem in obstructive apnea. Consequently, interdisciplinary interventions are crucial for effectively treating these patients. TRIAL REGISTRATION: The study was approved by the Ethics Committee of Philipps-University Marburg (reg. no. 13/22-2022) and registered at the "German Clinical Trial Register, DRKS" (DRKS0002959).


Assuntos
Eletromiografia , Polissonografia , Apneia Obstrutiva do Sono , Bruxismo do Sono , Humanos , Masculino , Feminino , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/complicações , Bruxismo do Sono/complicações , Bruxismo do Sono/fisiopatologia , Pessoa de Meia-Idade , Estudos Prospectivos , Músculo Masseter/fisiopatologia , Saúde Bucal , Adulto , Tono Muscular/fisiologia
2.
Scott Med J ; 23(4): 307-9, 1978 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-725583

RESUMO

Thirty-two patients were treated with the combination of tranylcypromine and trifluoperazine (Parstelin). The patients fell into 3 clinical groups, namely, endogenous depression (7 patients), neurotic depressive reaction (10 patients) and phobic anxiety with some depressive features (15 patients). Satisfactory response was found in 10 out of the 15 patients with phobic symptoms. The response in the other 2 groups was not significant. Side effects were troublesome in the neurotic depressive reaction group. In the phobic group the symptoms of the patients who responded were inclined to recur when the treatment was discontinued. It is considered that it is a useful preparation in the treatment of some phobic patients, but one must expect that the patients are likely to have to remain on the drug for long periods of time.


Assuntos
Transtornos Neuróticos/tratamento farmacológico , Tranilcipromina/uso terapêutico , Trifluoperazina/uso terapêutico , Adulto , Idoso , Transtornos de Ansiedade/tratamento farmacológico , Depressão/tratamento farmacológico , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Fóbicos/tratamento farmacológico , Tranilcipromina/efeitos adversos , Trifluoperazina/efeitos adversos
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