Spontaneous rhythmic masticatory muscle activity (RMMA) during sleep occurs in relation to transient activation in the cerebral and autonomic nervous systems of normal subjects and in patients with sleep bruxism (SB). In this study, we made a quantitative assessment of the sequential changes in cortical electroencephalographic (EEG) and autonomic-cardiac activities associated with micro-arousals preceding RMMA episodes. We matched 10 SB patients with 10 normal subjects. The onset of RMMA episodes was defined in terms of the onset of activation in the suprahyoid muscles. In SB patients, an increase in cortical EEG activity was observed 4 seconds before the onset of suprahyoid activity in 79% of episodes. A significant acceleration in heart rate was initiated one cardiac cycle before RMMA onset. A clear sequence of cortical to autonomic-cardiac activation precedes jaw motor activity in SB patients. This suggests that SB is a powerful oromotor manifestation secondary to micro-arousal.
American Sleep Disorders Association (ASDA) ( 1992). Arousals scoring rules and examples: a preliminary report from sleep disorders atlas task force of the American Sleep Disorders Association . Sleep15:173-184.
2.
Amzica F., Steriade M. (1997). The K-complex: its slow (< 1-Hz) rhythmicity and relation to delta waves. Neurology49:952-959.
3.
Bader GG, Kampe T., Tagdae T., Karlsson S., Blomqvist M. (1997). Descriptive physiological data on a sleep bruxism population. Sleep20:982-990.
4.
Bonnet MH, Arand DL (1997). Heart rate variability: sleep stage, time of night, and arousal influences. Electroencephal Clin Neurophysiol102:390-396.
5.
Boselli M., Parrino L., Smerieri A., Terzano MG (1998). Effect of age on EEG arousals in normal sleep . Sleep21:351-357.
6.
Brunner DP, Dijk D.-J, Borbely AA (1990). A quantitative analysis of phasic and tonic submental EMG activity in human sleep. Physiol Behav48:741-748.
7.
Coleman RM (1982). Periodic movements in sleep (nocturnal myoclonus) and restless legs syndrome. In: Sleeping and waking disorders, indications and techniques. Guilleminault C. editor. Menlo Park, CA: Addison-Wesley , pp. 265-295.
8.
Halasz P., Ujszaszi J., Gadoros J. (1985). Are microarousals preceded by electroencephalographic slow wave synchronization precursors of confusional awakenings? Sleep8:231-238.
9.
Ikeda T., Nishigawa K., Kondo K., Takeuchi H., Clark GT (1996). Criteria for the detection of sleep associated bruxism in humans. J Orofac Pain10:270-282.
10.
Karadeniz D., Ondze B., Besset A., Billiard M. (2000). EEG arousals and awakenings in relation with periodic leg movements during sleep. J Sleep Res9:273-277.
11.
Kato T., Montplaisir JY, Blanchet PJ, Lund JP, Lavigne GJ (1999). Idiopathic myoclonus in the oromandibular region during sleep: a possible source of confusion in sleep bruxism diagnosis. Mov Disord14:865-871.
12.
Lavigne GJ, Manzini C. (2000). Bruxism. In: Principles and practice of sleep medicine. 3rd ed. Kryger M, Roth T, Dement WC, editors. Philadelphia: W.B. Saunders Co., pp. 773-785.
Lavigne GJ, Rompre PH, Montplaisir JY (1996). Sleep bruxism: validity of clinical research diagnostic criteria in a controlled polysomnographic study. J Dent Res75:546-552.
15.
Macaluso GM, Guerra P., Di Giovanni G., Boselli M., Parrino L., Terzano MG (1998). Sleep bruxism is a disorder related to periodic arousals during sleep. J Dent Res77:565-573.
16.
Montagna P., Lugaresi E., Plazzi G. (1997). Motor disorders in sleep. Eur Neurol38:190-197.
17.
Montplaisir J., Boucher S., Gosselin A., Poirier G., Lavigne G. (1996). Persistence of repetitive EEG arousals (K-alpha complexes) in RLS patients treated with L-dopa. Sleep19:196-199.
18.
Okeson JP, Phillips BA, Berry Dtr, Baldwin RM (1994). Nocturnal bruxing events: a report of normative data and cardiovascular response. J Oral Rehabil21:623-630.
19.
Okura K., Nakano M., Bando E., Kondo K., Takeuchi H., Nishigawa K., et al. (1996). Analysis of biological signals during sleep associated bruxism. J Jpn Soc Stomatognath Funct3:83-93 (in Japanese with English abstract).
20.
Otzenberger H., Simon C., Gronfier C., Brandenberger G. (1997). Temporal relationship between dynamic heart rate variability and electroencephalographic activity during sleep in man. Neurosci Lett229:173-176.
21.
Rechtschaffen A., Kales A. (1968). A manual of standardized terminology, techniques and scoring techniques for sleep stages of human subjects. Los Angeles: Brain Information Service, Brain Research Institute.
22.
Reding GR, Zepelin H., Robinson JE Jr, Zimmerman SO, Smith VH (1968). Nocturnal teeth-grinding: all-night psychophysiologic studies. J Dent Res47:786-797.
23.
Satoh T., Harada Y. (1973). Electrophysiological study on tooth-grinding during sleep. Electroencephal Clin Neurophysiol35:267-275. Schondorf R. (1993). New investigations of autonomic nervous system function. J Clin Neurophysiol10:28-39.
24.
Sforza E., Nicolas A., Lavigne G., Gosselin A., Petit D., Montplaisir J. (1999). EEG and cardiac activation during periodic leg movements in sleep: support for a hierarchy of arousal response. Neurology52:786-791.
25.
Sjoholm T., Lehtinen I., Helenius H. (1995). Masseter muscle activity in diagnosed sleep bruxists compared with non-symptomatic controls. J Sleep Res4:48-55.
26.
Thropy MJ (1997). International Classification of Sleep Disorders: diagnostic and coding manual. Rochester, MN: American Sleep Disorders Association.
27.
Velly Miguel AM, Montplaisir JY, Rompre PH, Lund JP, Lavigne GJ (1992). Bruxism and other orofacial movements during sleep . J Craniomand Disord: Fac Oral Pain6:71-81.
28.
Winkelman JW (1999). The evoked heart rate response to periodic leg movements of sleep. Sleep22:575-580.
