Masticatory muscle sleep background electromyographic activity is elevated in myofascial temporomandibular disorder patients

Karen Raphael, M. N. Janal, David Sirois, B. Dubrovsky, P. E. Wigren, J. J. Klausner, A. C. Krieger, G. J. Lavigne

Research output: Contribution to journalArticle

Abstract

Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n = 124) with a demographically matched control group without TMD (n = 46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artefacts were removed. Results indicated that median background EMG during these non-SB event periods was significantly higher (P < 0·01) for women with myofascial TMD (median = 3·31 μV and mean = 4·98 μV) than for control women (median = 2·83 μV and mean = 3·88 μV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0-10 numerical scale) on post-sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance.

Original languageEnglish (US)
Pages (from-to)883-891
Number of pages9
JournalJournal of Oral Rehabilitation
Volume40
Issue number12
DOIs
StatePublished - Dec 2013

Fingerprint

Masticatory Muscles
Temporomandibular Joint Disorders
Electromyography
Sleep
Sleep Bruxism
Masseter Muscle
Bruxism
Pain
Artifacts
Case-Control Studies
Tooth
Research Design
Maintenance
Light
Control Groups

Keywords

  • Bruxism
  • EMG
  • Muscle tone
  • Myofascial pain
  • Polysomnography
  • Sleep
  • Sleep bruxism
  • Temporomandibular disorders
  • TMD

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Masticatory muscle sleep background electromyographic activity is elevated in myofascial temporomandibular disorder patients. / Raphael, Karen; Janal, M. N.; Sirois, David; Dubrovsky, B.; Wigren, P. E.; Klausner, J. J.; Krieger, A. C.; Lavigne, G. J.

In: Journal of Oral Rehabilitation, Vol. 40, No. 12, 12.2013, p. 883-891.

Research output: Contribution to journalArticle

Raphael, Karen ; Janal, M. N. ; Sirois, David ; Dubrovsky, B. ; Wigren, P. E. ; Klausner, J. J. ; Krieger, A. C. ; Lavigne, G. J. / Masticatory muscle sleep background electromyographic activity is elevated in myofascial temporomandibular disorder patients. In: Journal of Oral Rehabilitation. 2013 ; Vol. 40, No. 12. pp. 883-891.
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abstract = "Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n = 124) with a demographically matched control group without TMD (n = 46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artefacts were removed. Results indicated that median background EMG during these non-SB event periods was significantly higher (P < 0·01) for women with myofascial TMD (median = 3·31 μV and mean = 4·98 μV) than for control women (median = 2·83 μV and mean = 3·88 μV) with median activity in 72{\%} of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0-10 numerical scale) on post-sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance.",
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AU - Wigren, P. E.

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AU - Krieger, A. C.

AU - Lavigne, G. J.

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AB - Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n = 124) with a demographically matched control group without TMD (n = 46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artefacts were removed. Results indicated that median background EMG during these non-SB event periods was significantly higher (P < 0·01) for women with myofascial TMD (median = 3·31 μV and mean = 4·98 μV) than for control women (median = 2·83 μV and mean = 3·88 μV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0-10 numerical scale) on post-sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance.

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