Neurobiological Mechanisms Involved in Sleep Bruxism

SAGE Publications - Tập 14 Số 1 - Trang 30-46 - 2003
Gilles Lavigne1, Takafumi Kato2, Arlette Kolta3, Barry J. Sessle4
1Facultés de Médecine et Médecine dentaire, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, PQ, Canada H3C 3J7, Centre d’étude du sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, PQ, Canada, and Faculty of Dentistry, University of Toronto, Toronto, ON, Canada;
2Centre d’étude du sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada
3Faculté de Médecine dentaire, Université de Montréal, Montréal, PQ, Canada
4Faculty of Dentistry, University of Toronto, Toronto, ON, Canada

Tóm tắt

Sleep bruxism (SB) is reported by 8% of the adult population and is mainly associated with rhythmic masticatory muscle activity (RMMA) characterized by repetitive jaw muscle contractions (3 bursts or more at a frequency of 1 Hz). The consequences of SB may include tooth destruction, jaw pain, headaches, or the limitation of mandibular movement, as well as tooth-grinding sounds that disrupt the sleep of bed partners. SB is probably an extreme manifestation of a masticatory muscle activity occurring during the sleep of most normal subjects, since RMMA is observed in 60% of normal sleepers in the absence of grinding sounds. The pathophysiology of SB is becoming clearer, and there is an abundance of evidence outlining the neurophysiology and neurochemistry of rhythmic jaw movements (RJM) in relation to chewing, swallowing, and breathing. The sleep literature provides much evidence describing the mechanisms involved in the reduction of muscle tone, from sleep onset to the atonia that characterizes rapid eye movement (REM) sleep. Several brainstem structures ( e.g., reticular pontis oralis, pontis caudalis, parvocellularis) and neurochemicals ( e.g., serotonin, dopamine, gamma aminobutyric acid [GABA], noradrenaline) are involved in both the genesis of RJM and the modulation of muscle tone during sleep. It remains unknown why a high percentage of normal subjects present RMMA during sleep and why this activity is three times more frequent and higher in amplitude in SB patients. It is also unclear why RMMA during sleep is characterized by co-activation of both jaw-opening and jaw-closing muscles instead of the alternating jaw-opening and jaw-closing muscle activity pattern typical of chewing. The final section of this review proposes that RMMA during sleep has a role in lubricating the upper alimentary tract and increasing airway patency. The review concludes with an outline of questions for future research.

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