title: Validity of self-reported sleep bruxism among myofascial temporomandibular disorder patients and controls.
abstract: Sleep bruxism (SB), primarily involving rhythmic grinding of the teeth during sleep, has been advanced as a causal or maintenance factor for a variety of oro-facial problems, including temporomandibular disorders (TMD). As laboratory polysomnographic (PSG) assessment is extremely expensive and time-consuming, most research testing this belief has relied on patient self-report of SB. The current case-control study examined the accuracy of those self-reports relative to laboratory-based PSG assessment of SB in a large sample of women suffering from chronic myofascial TMD (n = 124) and a demographically matched control group without TMD (n = 46). A clinical research coordinator administered a structured questionnaire to assess self-reported SB. Participants then spent two consecutive nights in a sleep laboratory. Audiovisual and electromyographic data from the second night were scored to assess whether participants met criteria for the presence of 2 or more (2+) rhythmic masticatory muscle activity episodes accompanied by grinding sounds, moderate SB, or severe SB, using previously validated research scoring standards. Contingency tables were constructed to assess positive and negative predictive values, sensitivity and specificity, and 95% confidence intervals surrounding the point estimates. Results showed that self-report significantly predicted 2+ grinding sounds during sleep for TMD cases. However, self-reported SB failed to significantly predict the presence or absence of either moderate or severe SB as assessed by PSG, for both cases and controls. These data show that self-report of tooth grinding awareness is highly unlikely to be a valid indicator of true SB. Studies relying on self-report to assess SB must be viewed with extreme caution.
authors.affiliation: Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, New York, NY, USA.
authors.forename: K G
authors.initials: KG
authors.lastname: Raphael
authors.affiliation: Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY, USA.
authors.forename: M N
authors.initials: MN
authors.lastname: Janal
authors.affiliation: Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, New York, NY, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Sirois
authors.affiliation: New York Methodist Hospital, Center for Sleep Disorders Medicine and Research, Brooklyn, NY, USA.
authors.forename: B
authors.initials: B
authors.lastname: Dubrovsky
authors.affiliation: Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, New York, NY, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Klausner
authors.affiliation: Departments of Medicine, Neurology and Neuroscience, and Genetic Medicine, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Krieger
authors.affiliation: Faculté de Médecine Dentaire, Université de Montréal, Montréal, QC, Canada.
authors.forename: G J
authors.initials: GJ
authors.lastname: Lavigne
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017286:Polysomnography / Q000379:methods; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D020186:Sleep Bruxism / Q000150:complications / Q000175:diagnosis*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000150:complications*
keywords: TMD; bruxism; myofascial pain; polysomnography; screening; self-report; sleep; sleep bruxism; temporomandibular disorders