Effects of continuous positive airway pressure and mandibular advancement appliance therapy on sleep bruxism in adults with obstructive sleep apnea: a pilot study

Study objectives This study aimed to investigate the effects of continuous positive airway pressure (CPAP) and mandibular advancement appliance (MAA) therapy on rhythmic masticatory muscle activity (RMMA), a biomarker of sleep bruxism (SB), and to compare the effects of CPAP with MAA in adults with obstructive sleep apnea (OSA). Methods This cohort study included individuals with OSA who received treatment with CPAP or MAA. Polysomnographic recordings with and without therapy were performed in each individual. Statistical analyses were performed with repeated measures ANOVA. Results A total of 38 individuals with OSA were enrolled, 13 on CPAP and 25 with MAA, mean age 52.6 ± 10.6 years, 32 men, mean baseline apnea-hypopnea index (AHI) 26.5 ± 15.2 events/hour, mean RMMA index 3.5 ±events/hour. In the total group, the RMMA index decreased significantly with CPAP and MAA therapies ( P < 0.05). The changes in the RMMA index with therapy did not differ significantly between CPAP and MAA ( P > 0.05). The RMMA index decreased in 60% of the individuals with OSA, and the changes ranged widely, with a median of 52% and an interquartile range of 107%. Conclusions Both CPAP and MAA therapies significantly reduce SB in individuals with OSA. However, the interindividual differences in the effects of these therapies on SB are large. Clinical Trial Registration: https://trialsearch.who.int (NL8516); April 08, 2020