Ambulatory polysomnography for the assessment of sleep bruxism.
ABSTRACT Ambulatory polysomnography (PSG) is introduced as a new method for assessing sleep bruxism. Nocturnal recordings of masseter electromyography (EMG), electro-encephalography, electro-oculography, electrocardiography, thoracic effort and body position allow for the detection of typical nocturnal masseter activity as well as the determination of sleep stages. Twelve patients with a clinical diagnosis of bruxism were assessed with the ambulatory PSG, all of them fulfilled diagnostic PSG criteria according to Kato et al. (Dent Clin North Am. 2001; 45: 657-684). Per hour of sleep patients showed 34.2 (+/-10.6) EMG bursts and 5.6 (+/-1.3) sleep bruxism episodes. Because of the ability to determine sleep stages and the application in the home environment the ambulatory PSG represents a cost-saving alternative to sleep laboratory investigations that might be especially useful in field studies and clinical application.
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ABSTRACT: Recently, portable sleep recording devices became an accepted alternative to polysomnography (PSG) for obstructive sleep apnoea (OSA) diagnosis in patients with a high pre-test probability of moderate to severe OSA but home polysomnography (H-PSG) was not recommended because there was insufficient data. The present review has analysed six prospective randomiszed cross-over studies comparing H-PSG to in-lab PSG. These studies convincingly showed that H-PSG allows complete sleep evaluation. The quality of patient's sleep tends to be better at home. H-PSG is accurate for OSA diagnosis and the failure rate is low despite the absence of supervision. In addition, it could offer a final and comprehensive diagnosis for many other sleep disorders. It is also likely that H-PSG can reduce PSG-related costs but complete cost-effectiveness analyses are not yet available. Recently, remotely attended H-PSG via telemonitoring has been tested and may reduce H-PSG failure rate. In conclusion, H-PSG can be used to rule-in and rule out OSA in suspected patients, even in the presence of co-morbidities and is an alternative when type 3 recording is negative. Future developments should target simplification of technical aspects of H-PSG, together with remote monitoring, in order to obtain good quality H-PSG performed in adequate conditions.Sleep Medicine Reviews 01/2013; · 8.68 Impact Factor
- Sleep Medicine Clinics 01/2010; 5(1):9-35.
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ABSTRACT: Based on the most recent polysomnographic (PSG) research diagnostic criteria, sleep bruxism is diagnosed when >2 rhythmic masticatory muscle activity (RMMA)/h of sleep are scored on the masseter and/or temporalis muscles. These criteria have not yet been validated for portable PSG systems. This pilot study aimed to assess the diagnostic accuracy of scoring sleep bruxism in absence of audio-video recordings. Ten subjects (mean age 24.7 ± 2.2) with a clinical diagnosis of sleep bruxism spent one night in the sleep laboratory. PSG were performed with a portable system (type 2) while audio-video was recorded. Sleep studies were scored by the same examiner three times: (1) without, (2) with, and (3) without audio-video in order to test the intra-scoring and intra-examiner reliability for RMMA scoring. The RMMA event-by-event concordance rate between scoring without audio-video and with audio-video was 68.3 %. Overall, the RMMA index was overestimated by 23.8 % without audio-video. However, the intra-class correlation coefficient (ICC) between scorings with and without audio-video was good (ICC = 0.91; p < 0.001); the intra-examiner reliability was high (ICC = 0.97; p < 0.001). The clinical diagnosis of sleep bruxism was confirmed in 8/10 subjects based on scoring without audio-video and in 6/10 subjects with audio-video. Although the absence of audio-video recording, the diagnostic accuracy of assessing RMMA with portable PSG systems appeared to remain good, supporting their use for both research and clinical purposes. However, the risk of moderate overestimation in absence of audio-video must be taken into account.Sleep And Breathing 05/2014; · 2.26 Impact Factor