The purpose of this post is to open a conversation regarding the implicacations on 2 aspects of bruxism:
- The amplitude as measured in microvolts (uV)
- The occurance of the bruxism in relation to a respiratory disturbance
In viewing this sample epoch collected by the NOX-T3, there are notable observations which I would like
to open for discussion:
The first bruxism is well over 100uV in amplitude which is in stark contrast to the other bruxisms seen. One
possible explanation for the increased amplitude compared to the other bruxisms noted is that tooth contact
is made which would have the effect of creating a much stronger EMG signal. Another distinction noted on
the first bruxism is that it proceeds the obstructive event. With these observations one MIGHT conclude
the first bruxism is independent to this patient obvious OSA. There are other conclusions that may be
drawn as well for which I would like the group to coment on.
The second bruxism noted in this epoch is approximately 25uV and is much more common in this patients
sleep study. It also occurs within the OSA event and appears to be part the OSA arousal response.
One more comment on the second and smaller bruxism is that it occurs early in the arousal response and
likely proceeds the EEG arousal but during the obstruction hinting that the massetter is being used to
some how “stimulate” the musculature of the airway.
If it is true this patient has 2 distinct and seperate types of bruxism, my questions as a non-dentist are:
How important is it to know the difference between apnea realted bruxism and “idiopathic” bruxism?
What, if any treatment changes would be recommended with this patient knowing there are 2 types of bruxing?