title: Bruxism in children: effect on sleep architecture and daytime cognitive performance and behavior.
abstract: OBJECTIVE
  Sleep bruxism is an involuntary mandibular movement with tooth grinding during sleep. The prevalence of sleep bruxism in children is high and may lead to frequent arousals with altered daytime functioning. We investigated the sleep architecture, the incidence of gastroesophageal reflux, and the daytime cognitive behavioral functioning in a group of children with sleep bruxism. DESIGN-PATIENTS: This prospective pilot study included 10 children. Polysomnographic data with pH-probe analysis was compared with 10 age- and sex-matched controls. Each patient completed a dental evaluation, a nighttime polysomnogram, and cognitive behavioral tests (Kaufman Brief Intelligence Test and Achenbach Child Behavior Checklist).
  
  
  RESULTS
  Eight of 10 children had clinically significant bruxism and the 2 remaining patients had recent teeth exfoliation. There was no difference on sleep architecture between patients and controls, except for a higher arousal index for the bruxism group (36.7 vs 20.7, p < .007). Sleep bruxism occurred more frequently in stage 2 and rapid eye movement sleep, with arousals in 66% of the cases. There was no relationship of bruxism to gastroesophageal reflux or intelligence. However, 40% of the patients had elevated scores on the Achenbach Child Behavior Checklist, indicating significant attention and behavior problems, and there were moderate correlations between the arousal index and several of the behavior-problem scales from the Achenbach Child Behavior Checklist (0.5 to 0.6).
  
  
  CONCLUSIONS
  The data suggest that children with bruxism have a higher arousal index, which may be associated with an increased incidence of attention-behavior problems. Future studies investigating pediatric sleep bruxism will need to focus on behavior issues that may be prevalent in this population.
authors.affiliation: Department of Dental Medicine, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA [corrected] USA. marceher@dental.upenn.edu
authors.forename: Marcela
authors.initials: M
authors.lastname: Herrera
authors.forename: Ignacio
authors.initials: I
authors.lastname: Valencia
authors.forename: Mitzie
authors.initials: M
authors.lastname: Grant
authors.forename: David
authors.initials: D
authors.lastname: Metroka
authors.forename: Augustine
authors.initials: A
authors.lastname: Chialastri
authors.forename: Sanjeev V
authors.initials: SV
authors.lastname: Kothare
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000503:physiopathology; D008410:Masticatory Muscles / Q000294:innervation; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D010865:Pilot Projects; D017286:Polysomnography; D015995:Prevalence; D011446:Prospective Studies; D020186:Sleep Bruxism / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012894:Sleep Stages / Q000502:physiology; D014851:Wakefulness / Q000502:physiology