IADR Abstract Archives
The Effect of a Dopaminergic Agonist on Sleep Bruxism
Objectives: Sleep bruxism (SB) is a “stereotyped movement disorder characterized by grinding or clenching of the teeth during sleep” with potential adverse clinical consequences. SB bears several similarities with the restless leg syndrome (RLS) and altered central dopaminergic activity has been linked to both conditions. Dopamine agonists are commonly applied in RLS. The current study examined the effect of the dopamine agonist pramipexole (PPX) on bruxism in patients with clinically established bruxism.
Methods: Otherwise healthy patients with a history/clinical signs of SB (n=20) were recruited from the Orofacial Pain Clinic. Ambulatory polysomnography (PSG), including recordings of bilateral masseter electromyographic (EMG) activity, was applied in the sleep medicine unit. This open 2-way cross-over study compared pramipexole (PPX Bluefish Pharma®) and control conditions applied in a randomized treatment order. The protocol included a habituation night with the sleep recording equipment and a routine for forced dose titration of PPX to 0.54mg o.d. during three weeks. Sleep variables, including bursts and episodes of SB, were scored and quantified according to conventional criteria at baseline as well as after PPX and control conditions respectively.
Results: The protocol was completed by 13 patients and 7 (35%) dropped out at various points in time. Two patients experienced disturbed sleep but lack of time/family reasons was the dominant cause of drop-out. SB severity, total episodes per hour, mean/h (SD) at baseline did not differ between those completing (11.3 (6.3)) and those interrupting (8.6 (4.3)) the study. The number of bursts and phasic, tonic or mixed bruxism episodes were found to increase after PPX (total episodes/h 12.7 (8.5)) compared with control conditions (9.8 (5.2)) but this difference was not significant after adjustment for period effect.
Conclusions: Episodes of bruxism during sleep were unaffected by the dopamine agonist pramipexole in patients with SB.
Methods: Otherwise healthy patients with a history/clinical signs of SB (n=20) were recruited from the Orofacial Pain Clinic. Ambulatory polysomnography (PSG), including recordings of bilateral masseter electromyographic (EMG) activity, was applied in the sleep medicine unit. This open 2-way cross-over study compared pramipexole (PPX Bluefish Pharma®) and control conditions applied in a randomized treatment order. The protocol included a habituation night with the sleep recording equipment and a routine for forced dose titration of PPX to 0.54mg o.d. during three weeks. Sleep variables, including bursts and episodes of SB, were scored and quantified according to conventional criteria at baseline as well as after PPX and control conditions respectively.
Results: The protocol was completed by 13 patients and 7 (35%) dropped out at various points in time. Two patients experienced disturbed sleep but lack of time/family reasons was the dominant cause of drop-out. SB severity, total episodes per hour, mean/h (SD) at baseline did not differ between those completing (11.3 (6.3)) and those interrupting (8.6 (4.3)) the study. The number of bursts and phasic, tonic or mixed bruxism episodes were found to increase after PPX (total episodes/h 12.7 (8.5)) compared with control conditions (9.8 (5.2)) but this difference was not significant after adjustment for period effect.
Conclusions: Episodes of bruxism during sleep were unaffected by the dopamine agonist pramipexole in patients with SB.