title: Evaluation of a Proton Pump Inhibitor for Sleep Bruxism: A Randomized Clinical Trial.
abstract: Bruxism is a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and/or bracing or thrusting of the mandible. Recent advances have clarified the relationship between gastroesophageal reflux and sleep bruxism (SB). However, the influence of pharmacological elimination of gastric acid secretion on SB has not been confirmed. The authors aimed to assess the efficacy of a proton pump inhibitor (PPI) on SB and to examine the gastrointestinal (GI) symptoms and endoscopic findings of the upper GI tract in SB patients. The authors performed a randomized double-blind placebo-controlled crossover study at Kagoshima University Hospital. Twelve patients with polysomnography (PSG)-diagnosed SB underwent an assessment of GI symptoms using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) and esophagogastroduodenoscopy. At baseline (i.e., before interventions), the mean frequencies of electromyography (EMG) bursts and rhythmic masticatory muscle activity (RMMA) episodes were 65.4 ± 49.0 bursts/h and 7.0 ± 4.8 episodes/h, respectively, and at least 1 RMMA episode with grinding noise was confirmed in all participants. The mean FSSG score was 8.4 ± 5.6, and 41.7% of patients were diagnosed with gastroesophageal reflux disease. Mild reflux esophagitis was confirmed in 6 patients. PSG, including EMG of the left masseter muscle and audio-video recording, was performed on days 4 and 5 of administration of 10 mg of the PPI (rabeprazole) or placebo. PPI administration yielded a significant reduction in the frequency of EMG bursts, RMMA episodes, and grinding noise. No significant differences were observed regarding the swallowing events and sleep variables. Since the clinical application of PPI for SB treatment should remain on hold at present, the results of this trial highlight the potential application of pharmacological gastroesophageal reflux disease treatment for SB patients. Larger scale studies are warranted to corroborate these findings. (UMIN Clinical Trials Registry: UMIN000004577).
authors.affiliation: Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ohmure
authors.affiliation: Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kanematsu-Hashimoto
authors.affiliation: Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nagayama
authors.affiliation: Department of Digestive Disease and Lifestyle related Disease, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Taguchi
authors.affiliation: Department of Digestive Disease and Lifestyle related Disease, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Ido
authors.affiliation: Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tominaga
authors.affiliation: Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Arakawa
authors.affiliation: Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan miyawaki@dent.kagoshima-u.ac.jp.
authors.forename: S
authors.initials: S
authors.lastname: Miyawaki
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004576:Electromyography; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D020186:Sleep Bruxism / Q000150:complications* / Q000188:drug therapy*
chemical_list: D054328:Proton Pump Inhibitors
keywords: crossover studies; deglutition; double-blind method; gastroesophageal reflux; placebos; randomized controlled trial