Effect of clonazepam and clonidine on primary sleep bruxism: a double-blind, crossover, placebo-controlled trial
Effect of clonazepam and clonidine on primary sleep bruxism: a double-blind, crossover, placebo-controlled trial
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DOI：
10.1111/jsr.12442
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发表时间：
2017-02-01
影响因子：
4.4
通讯作者：
Baba, Kazuyoshi
中科院分区：
文献类型：
--
作者：
Sakai, Takuro;Kato, Takafumi;Baba, Kazuyoshi
本研究的目的是评估氯硝西泮和可乐定对原发性睡眠磨牙症年轻成人节律性咀嚼肌活动的急性影响，以及对睡眠结构和心脏活动的伴随影响。本研究采用双盲、交叉、安慰剂对照设计。对19名受试者[9名男性和10名女性;平均年龄（+/- SE）：25.4 +/- 2.7岁]进行了5个晚上的多导睡眠描记术。前2个晚上用于习惯和诊断睡眠磨牙症。另外3个晚上随机分配氯硝西泮（1.0 mg），可乐定（0.15 mg）或安慰剂（均在睡前30分钟给药）。在三种药物条件下评估和比较睡眠、运动和心脏活动变量。与安慰剂和氯硝西泮相比，可乐定显著降低了快速眼动睡眠阶段的中位时间百分比。与安慰剂和氯硝西泮相比，可乐定使咀嚼肌节律性活动发作次数减少> 30%。可乐定降低节律性咀嚼肌活动指数与安静睡眠期间和节律性咀嚼肌活动发作前70 s期间的平均RR间期（心率减慢）增加相关。然而，氯硝西泮未观察到心脏活动变量的变化。在患有原发性夜磨牙症的年轻人中，可乐定在抑制夜磨牙症方面明显比氯硝西泮更有效。可乐定对节律性咀嚼肌活动发作的急性效应可能通过抑制自主神经系统活动和非快速眼动-快速眼动睡眠过程来介导。
The aim of this study was to assess the acute effects of clonazepam and clonidine on rhythmic masticatory muscle activity in young adults with primary sleep bruxism, as well as accompanying effects on sleep architecture and cardiac activity. This study used a double-blind, crossover, placebo-controlled design. Polysomnography was performed on 19 subjects [nine men and 10 women; mean age (+/- SE): 25.4 +/- 2.7 years] for 5 nights. The first 2 nights were used for the habituation and diagnosis of sleep bruxism. The other 3 nights were randomly assigned for clonazepam (1.0 mg), clonidine (0.15 mg) or placebo (all administered 30 min before bedtime). Sleep, oromotor activity and cardiac activity variables were assessed and compared among the three drug conditions. Clonidine significantly reduced the median percentage of time spent in the rapid eye movement sleep stage compared with placebo and clonazepam. The number of rhythmic masticatory muscle activity episodes was reduced with clonidine by > 30% compared with placebo and clonazepam. The reduction of rhythmic masticatory muscle activity index by clonidine was associated with an increase of mean RR intervals (slower heart rate) during quiet sleep periods and during a 70-s period before the onset of rhythmic masticatory muscle activity episodes. However, no changes in cardiac activity variables were observed for clonazepam. In young adults with primary sleep bruxism, clonidine was significantly more effective in suppressing sleep bruxism than clonazepam. The acute effects of clonidine on rhythmic masticatory muscle activity episodes may be mediated by suppression of autonomic nervous system activity and nonrapid eye movement-rapid eye movement sleep processes.