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Validity of self‐reported sleep bruxism among myofascial temporomandibular disorder patients and controls
Author(s) -
Raphael K. G.,
Janal M. N.,
Sirois D. A.,
Dubrovsky B.,
Klausner J. J.,
Krieger A. C.,
Lavigne G. J.
Publication year - 2015
Publication title -
journal of oral rehabilitation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.991
H-Index - 93
eISSN - 1365-2842
pISSN - 0305-182X
DOI - 10.1111/joor.12310
Subject(s) - sleep bruxism , medicine , masticatory force , confidence interval , physical therapy , polysomnography , dentistry , audiology , physical medicine and rehabilitation , electromyography , electroencephalography , psychiatry
Summary Sleep bruxism ( SB ), primarily involving rhythmic grinding of the teeth during sleep, has been advanced as a causal or maintenance factor for a variety of oro‐facial problems, including temporomandibular disorders ( TMD ). As laboratory polysomnographic ( PSG ) assessment is extremely expensive and time‐consuming, most research testing this belief has relied on patient self‐report of SB . The current case–control study examined the accuracy of those self‐reports relative to laboratory‐based PSG assessment of SB in a large sample of women suffering from chronic myofascial TMD ( n = 124) and a demographically matched control group without TMD ( n = 46). A clinical research coordinator administered a structured questionnaire to assess self‐reported SB . Participants then spent two consecutive nights in a sleep laboratory. Audiovisual and electromyographic data from the second night were scored to assess whether participants met criteria for the presence of 2 or more (2+) rhythmic masticatory muscle activity episodes accompanied by grinding sounds, moderate SB , or severe SB , using previously validated research scoring standards. Contingency tables were constructed to assess positive and negative predictive values, sensitivity and specificity, and 95% confidence intervals surrounding the point estimates. Results showed that self‐report significantly predicted 2+ grinding sounds during sleep for TMD cases. However, self‐reported SB failed to significantly predict the presence or absence of either moderate or severe SB as assessed by PSG , for both cases and controls. These data show that self‐report of tooth grinding awareness is highly unlikely to be a valid indicator of true SB . Studies relying on self‐report to assess SB must be viewed with extreme caution.