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Diagnostic accuracy of sleep bruxism scoring in absence of audio-video recording: a pilot study

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Abstract

Purpose

Based on the most recent polysomnographic (PSG) research diagnostic criteria, sleep bruxism is diagnosed when >2 rhythmic masticatory muscle activity (RMMA)/h of sleep are scored on the masseter and/or temporalis muscles. These criteria have not yet been validated for portable PSG systems. This pilot study aimed to assess the diagnostic accuracy of scoring sleep bruxism in absence of audio-video recordings.

Methods

Ten subjects (mean age 24.7 ± 2.2) with a clinical diagnosis of sleep bruxism spent one night in the sleep laboratory. PSG were performed with a portable system (type 2) while audio-video was recorded. Sleep studies were scored by the same examiner three times: (1) without, (2) with, and (3) without audio-video in order to test the intra-scoring and intra-examiner reliability for RMMA scoring.

Results

The RMMA event-by-event concordance rate between scoring without audio-video and with audio-video was 68.3 %. Overall, the RMMA index was overestimated by 23.8 % without audio-video. However, the intra-class correlation coefficient (ICC) between scorings with and without audio-video was good (ICC = 0.91; p < 0.001); the intra-examiner reliability was high (ICC = 0.97; p < 0.001). The clinical diagnosis of sleep bruxism was confirmed in 8/10 subjects based on scoring without audio-video and in 6/10 subjects with audio-video.

Conclusions

Although the absence of audio-video recording, the diagnostic accuracy of assessing RMMA with portable PSG systems appeared to remain good, supporting their use for both research and clinical purposes. However, the risk of moderate overestimation in absence of audio-video must be taken into account.

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Acknowledgments

The authors would like to thank Angela Nashed and Christiane Manzini for their support. The study was funded by the Canadian Institutes of Health Research (CIHR MOP grant 11701). M.C. Carra was granted a scholarship by the Ministère de l’Éducation, du Loisir et du Sport du Québec.

Conflict of interest

G.J. Lavigne holds a Canada Research Chair in Pain, Sleep and Trauma. He was consultant and lecturer for Pfizer (Wyeth) Canada; he received free or at reduced costs oral appliances, such as ORM-Narval, France-Canada, Silencer, Canada, and Klearway, Canada, used for research purposes on sleep-disordered breathing. N. Huynh has indicated no financial conflicts of interest.

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Authors and Affiliations

  1. Faculty of Dentistry, Université de Montréal, CP 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada

    Maria Clotilde Carra, Nelly Huynh & Gilles J. Lavigne

  2. Center for Advanced Research in Sleep Medicine, Hospital of Sacré-Cœur de Montréal, Université de Montréal, Montréal, Canada

    Maria Clotilde Carra, Nelly Huynh & Gilles J. Lavigne

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  1. Maria Clotilde Carra
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  2. Nelly Huynh
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  3. Gilles J. Lavigne
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Correspondence to Maria Clotilde Carra.

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Carra, M.C., Huynh, N. & Lavigne, G.J. Diagnostic accuracy of sleep bruxism scoring in absence of audio-video recording: a pilot study. Sleep Breath 19, 183–190 (2015). https://doi.org/10.1007/s11325-014-0986-9

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  • DOI: https://doi.org/10.1007/s11325-014-0986-9

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