title: Negative association between self-reported jaw symptoms and apnea-hypopnea index in patients with symptoms of obstructive sleep apnea syndrome: a pilot study.
abstract: OBJECTIVE
  Prior to oral appliance therapy for snoring and obstructive sleep apnea syndrome (OSAS), patients are screened for jaw symptoms (e.g., pain). However, the presence of jaw symptoms in a large spectrum of OSAS patients remains unknown. This study aimed to assess the distribution of subjective jaw symptoms in patients with symptoms of OSAS.
  
  
  METHODS
  Five hundred and eleven consecutive patients (66 female, 445 male; mean age 49.6 ± 12.6 years) with clinical symptoms of OSAS were enrolled for cardiorespiratory evaluation. Self-administered questionnaires were used to assess jaw symptoms, tooth grinding and clenching during sleep, morning oral dryness, morning heartburn sensation, and pain in the neck and back.
  
  
  RESULTS
  The mean apnea-hypopnea (AHI) index was 32.5 ± 30.6 per hour of sleep. Nineteen percent of patients (n = 96) reported at least one jaw symptom. The presence of jaw symptoms was more frequently reported by patients with AHI less than 15 (25 %) than those with AHI of 15 and more (15 %, p = 0.012). In the crude analyses, jaw symptoms were associated with tooth grinding, tooth clenching, morning oral dryness, morning heartburn sensation, and neck/back pain. Multiple logistic regression analysis confirmed that jaw symptoms were associated with AHI less than 15 (odds ratio (OR) 1.99, p = 0.009), tooth clenching (OR 1.79, p = 0.006), morning oral dryness (OR 2.17, p = 0.02), and neck/back pain (OR 1.99, p = 0.005).
  
  
  CONCLUSIONS
  Jaw symptoms can be found in 19 % of patients with symptoms of OSAS and are more frequently reported in patients with lower AHI, a patient population for whom oral appliances are often prescribed.
authors.affiliation: Department of Oral Anatomy and Neurobiology, Osaka University, Osaka, Japan. takafumi@dent.osaka-u.ac.jp
authors.forename: Takafumi
authors.initials: T
authors.lastname: Kato
authors.forename: Akira
authors.initials: A
authors.lastname: Mikami
authors.forename: Hideko
authors.initials: H
authors.lastname: Sugita
authors.forename: Hisae
authors.initials: H
authors.lastname: Muraki
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Okura
authors.forename: Motoharu
authors.initials: M
authors.lastname: Ohi
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Taniguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation; D008875:Middle Aged; D017090:Occlusal Splints; D010865:Pilot Projects; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult