Association between nocturnal bruxism and gastroesophageal reflux
Association between nocturnal bruxism and gastroesophageal reflux
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DOI：
10.1093/sleep/26.7.888
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发表时间：
2003-11-01
期刊：
影响因子：
5.6
通讯作者：
Takano-Yamamoto, T
中科院分区：
文献类型：
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作者：
Miyawaki, S;Tanimoto, Y;Takano-Yamamoto, T
研究目的：研究夜间磨牙症和胃食管返流之间的关系。设计：对照描述性研究和双盲，安慰剂对照，临床研究。设置：便携式pH值监测，肌电图，和音频视频记录进行了夜间在受试者的home.Participants：10名患者与磨牙症和10名正常受试者的身高，体重，年龄和性别相匹配。他们没有胃食管反流病的症状。干预措施：质子泵抑制剂药物治疗测量和结果：磨牙症组夜间咀嚼肌节律性活动（RMMA）发作频率明显较高（平均值+/-SD：6.7 +/-2.2次/小时）以及pH值低于4.0和5.0的胃食管反流发作的频率和时间百分比较高（分别为0.5 +/-0.9和3.6 +/-1.6次/小时，1.3%+/-2.5%和7.4%+/-12.6%）（RMMA发作：每小时2.4 +/-0.9次;胃食管反流发作：分别为0.0 +/-0.0和0.1 +/-0.3次/小时以及0.0%+/-0.0%和0.0% 0.0%）。在磨牙症组中，100%的pH值小于3.0和4.0的胃食管反流发作包括RMMA发作和肌电图爆发，持续时间约为0.5 - 1.0秒，可能代表吞咽唾液。在对照组和磨牙症组中，pH值为4.0 - 5.0的大多数胃食管反流发作也包括RMMA发作和肌电图爆发（100%+/-0.0% vs 70.7%+/-16.5%），同样可能是由于吞咽唾液。其余少数pH值为4.0 - 5.0的胃食管反流发作仅包含肌电爆发（吞咽唾液）。在对照组和磨牙症组中，质子泵抑制剂释放药物后（增加胃和食管pH值）RMMA发作的频率显著低于安慰剂给药后的频率（分别为1.0 ± 0.6 vs 1.9 ± 3.2次/小时和3.7 ± 1.9 vs 6.0 ± 2.2次/小时），结论：夜间磨牙症可能继发于夜间胃食管反流，通过睡眠觉醒发生，通常与吞咽同时发生。磨牙症和唾液分泌增加之间的生理联系需要研究。
Study Objective: To examine the relationship between nocturnal bruxism and gastroesophageal reflux.Design: Controlled descriptive study and double-blind, placebo-controlled, clinical study.Setting: Portable pH monitoring, electromyography, and audio-video recordings were conducted during the night in the subjects' home.Participants: Ten patients with bruxism and 10 normal subjects were matched for height, weight, age, and sex. They did not have symptoms of gastroesophageal reflux disease.Intervention: Medication with a proton pump inhibitor (ie, a gastric-acid-inhibiting drug).Measurements and Results: The bruxism group showed a significantly higher frequency of nocturnal rhythmic masticatory muscle activity (RMMA) episodes (mean +/- SD: 6.7 +/- 2.2 times per hour) and a higher frequency and percentage of time of gastroesophageal reflux episodes with a pH less than 4.0 and 5.0 (0.5 +/- 0.9 and 3.6 +/- 1.6 times per hour and 1.3% +/- 2.5% and 7.4% +/- 12.6%, respectively) than the control group (RMMA episodes: 2.4 +/- 0.9 times per hour; gastroesophageal reflux episodes: 0.0 +/- 0.0 and 0.1 +/- 0.3 times per hour and 0.0% +/- 0.0% and 0.0% 0.0%, respectively). In the bruxism group, 100% of the gastroesophageal reflux episodes with a pH less than 3.0 and 4.0 included both an RMMA episode and an electromyographic burst, the duration of which was approximately 0.5 to 1.0 seconds, probably representing swallowing of saliva. The majority of gastroesophageal reflux episodes with a pH of 4.0 to 5.0 also included both an RMMA episode and an electromyographic burst in the control and bruxism groups (100% +/- 0.0% vs 70.7% +/- 16.5%), again probably due to swallowing of saliva. The remaining minority of gastroesophageal reflux episodes with a pH of 4.0 to 5.0 contained only an electromyographic burst (swallowing of saliva). The frequency of RMMA episodes after the release of the medication from the proton pump inhibitor, which increased the gastric and esophageal pH, was significantly lower than that after administration of the placebo in the control and bruxism groups (1.0 +/- 0.6 vs 1.9 +/- 3.2 times per hour, and 3.7 +/- 1.9 vs. 6.0 +/- 2.2 times per hour, respectively),Conclusions: Nocturnal bruxism may be secondary to nocturnal gastroesophageal reflux, occurring via sleep arousal and often together with swallowing. The physiologic link between bruxism and the increase in salivation needs to be investigated.