Self-reported sleep bruxism and nocturnal gastroesophageal reflux disease in patients with obstructive sleep apnea: relationship to gender and ethnicity

Sean Hesselbacher, Shyam Subramanian, Shweta Rao, Lata Casturi, Salim Surani, Sean Hesselbacher, Shyam Subramanian, Shweta Rao, Lata Casturi, Salim Surani

Abstract

Study objectives: Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity.

Methods: A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group.

Results: In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians.

Conclusion: Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups.

Keywords: Gastroesophageal reflux; obstructive sleep apnea; sleep bruxism..

Figures

Fig. (1)
Fig. (1)
The Epworth Sleepiness score is higher in some patients with sleep-related bruxism and nocturnal GERD. The mean and standard deviation are shown for patients with (solid bar) and without (checkered bar) bruxism (A) and GERD (B). Subgroups by gender and ethnicity are identified by color. *P

Fig. (2)

The severity of obstructive sleep…

Fig. (2)

The severity of obstructive sleep apnea (OSA) is not associated with the presence…

Fig. (2)
The severity of obstructive sleep apnea (OSA) is not associated with the presence of with sleep-related bruxism or nocturnal GERD in patients with OSA. The mean and standard error of the mean of the apnea-hypopnea index (A, C) and lowest oxygen saturation (B, D) are shown for patients with (solid box, solid line) and without (open box, dashed line) bruxism (A, B) and GERD (C, D).
Fig. (2)
Fig. (2)
The severity of obstructive sleep apnea (OSA) is not associated with the presence of with sleep-related bruxism or nocturnal GERD in patients with OSA. The mean and standard error of the mean of the apnea-hypopnea index (A, C) and lowest oxygen saturation (B, D) are shown for patients with (solid box, solid line) and without (open box, dashed line) bruxism (A, B) and GERD (C, D).

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