The effect of 2 sympatholytic medications - Propranolol and clonidine - On sleep bruxism: Experimental Randomized controlled studies
The effect of 2 sympatholytic medications - Propranolol and clonidine - On sleep bruxism: Experimental Randomized controlled studies
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DOI：
10.1093/sleep/29.3.307
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发表时间：
2006-03-01
期刊：
影响因子：
5.6
通讯作者：
de Champlain, Jacques
中科院分区：
文献类型：
--
作者：
Huynh, Nelly;Lavigne, Gilles J.;de Champlain, Jacques
研究目的：研究两种交感神经药物能否在睡眠磨牙症发生前减少睡眠磨牙症和防止交感神经活动的增加：非选择性肾上腺素能β阻滞剂心得安和选择性α(2)激动剂克罗尼克林。设计：安慰剂和积极治疗(心得安120 mg；可乐定0.3 mg)的实验性随机对照交叉研究。地点：医院睡眠研究实验室。患者：25例有睡眠磨牙症病史和诊断的受试者(男性11例，女性14例；年龄21~31岁)。干预：多导睡眠实验测量和结果：进行了4个晚上的多导睡眠实验室记录：第一个晚上是习惯性睡眠，第二个是睡眠磨牙症诊断；3个和4个是学习之夜。用咬肌活动评估睡眠磨牙症指数。心率变异性通过RR间期的频谱分析进行评估。普萘洛尔对睡眠和睡眠磨牙症变量没有显著影响。平均RR间期和交感优势减少(P<；0.05)。在可乐定治疗下，16例磨牙症患者中有14例第二阶段睡眠时间延长，14例快速眼动睡眠受到抑制。睡眠磨牙症指数降低61%(p<；0.05)。在可乐定作用下，在稳定睡眠和睡眠磨牙症发生前一分钟，心率和交感神经支配能力减慢(p<；0.05)。结论：虽然心得安对睡眠磨牙症没有影响，但可乐定在睡眠磨牙症发生前一分钟降低了交感神经张力，从而阻止了睡眠磨牙症的自主神经到运动激活的顺序，从而减少了睡眠磨牙症。这进一步支持了交感神经活动在睡眠磨牙症的病理生理学中的作用，因为19%的患者出现了晨间低血压，需要进一步的密切相关研究来评估可乐定治疗睡眠磨牙症的安全性。
Study Objective: To examine whether 2 sympatholytic medications decrease sleep bruxism and prevent the rise in sympathetic activity preceding the onset of sleep bruxism: propranolol, a nonselective adrenergic beta-blocker, and clonicline, a selective alpha(2)-agonist.Design: Experimental randomized controlled crossover studies with placebo and active treatments (propranolol 120 mg; clonidine 0.3 mg).Setting: Hospital-based sleep research laboratory. Patients: Twenty-five subjects with a history and diagnosis of SLEEP BRUXISM (11 men, 14 women; age range, 21 to 31 years).Intervention: Polygraphic studyMeasurements and Results: Polygraphic sleep laboratory recordings were done for 4 nights: the first night was habituation, the second, sleep bruxism diagnosis; and 3 and 4 were study nights. The sleep bruxism index was estimated using masseter muscle activity. Heart rate variability was estimated with spectral analysis of RR intervals. Sleep and sleep bruxism variables were not significantly influenced by propranolol. A reduction of the mean RR intervals and of the sympathetic dominance (p < .05) was seen. Under clonidine, duration of sleep stage 2 was prolonged, whereas REM sleep was suppressed in 14 of 16 subjects with sleep bruxism. The ;sleep bruxism index was reduced by 61% (p < .05). Under clonidine, a reduction in heart rate and sympathetic dominance was observed in stable sleep and in the minute preceding the onset of sleep bruxism (p < .05).Conclusion: Although propranolol did not affect sleep bruxism, clonidine decreased sympathetic tone in the minute preceding the onset of sleep bruxism, thus reducing sleep bruxism by preventing the sequence of autonomic to motor activation of sleep bruxism. This further supports the role of sympathetic activity in the pathophysiology of sleep bruxism, Because morning hypotension was seen in 19% of patients, further close-dependant research is required to assess the safety of clonidine for the management of sleep bruxism.