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Effect of Occlusal Splint Therapy vs Sleep Hygiene and Progressive Muscle Relaxation on Perceived Stress and Sleep Bruxism
TAKE-HOME MESSAGE
- Occlusal splint therapy is usually prescribed in hopes of reducing stress and bruxism activity. This study compared the effects of an occlusal device with those of a combination of sleep hygiene and progressive muscle relaxation on perceived stress and sleep bruxism activity in 66 participants with self-reported sleep bruxism. Both interventions significantly reduced the number of bruxism episodes per hour and bursts per episode, with the occlusal device also showing a decrease in stress scores at 1 and 6 months compared with those at baseline. However, there was no statistically significant difference between the two groups in terms of perceived stress reduction. The study may benefit from a cross-over design or a combination treatment of both modalities.
- Clinicians may consider treating bruxism using a combination of multiple treatment modalities, such as occlusal devices, sleep hygiene, and muscle relaxation, to achieve better control of bruxism.
abstract
This abstract is available on the publisher's site.
Access this abstract nowPURPOSE
The objective was the comparison of an occlusal device (OD), and sleep hygiene and progressive muscle relaxation (SH & PMR) on perceived stress and sleep bruxism activity (burst/episode and episode/hour) in participants with sleep bruxism.
MATERIAL AND METHODS
Sixty-six participants with self-reported sleep bruxism were selected and randomly allocated into two groups: OD group or SH & PMR group. Assessment of perceived stress and sleep bruxism activity were the primary outcomes. The Perceived Stress Scale-10 (PSS-10 scale) was used to measure perceived stress and bruxism episodes/hour and bursts/episode recorded by electromyography of masseter and temporalis. These outcomes were assessed at baseline, 1 month, 6 months, and 1 year. The paired t-test assessed changes in PSS-10 scores and sleep bruxism activity within the same group over different time points (baseline, 1 month, 6 months, and 1 year). The unpaired t-test compared scores between two groups (OD and SH & PMR) at each time point to evaluate intervention differences. The chi-square test compared gender distribution between both groups.
RESULTS
PSS-10 scores were found to decrease with the OD at 1 month and 6 months compared to baseline and SH & PMR at all subsequent follow-ups. This decrease was not statistically significant (p > 0.05) between the OD and SH & PMR groups at all follow-ups. OD and SH & PMR significantly reduced bruxism episodes/hour and bursts/episode at all follow-ups (p < 0.05). There were no adverse effects related to any intervention.
CONCLUSIONS
The OD and SH & PMR both effectively reduced PSS-10 scores over 6 months and significantly decreased bruxism episodes and bursts per episode. Both methods are safe and effective for managing sleep bruxism and reducing stress.
Additional Info
Disclosure statements are available on the authors' profiles:
Efficacy of occlusal splint versus sleep hygiene and progressive muscle relaxation on perceived stress and sleep bruxism: A randomized clinical trial
J Prosthodont 2024 Aug 01;[EPub Ahead of Print], A Tandon, BP Singh, R Shanker, KK Agrawal, P Mahour, S TripathiFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The objective of this study was to compare the treatment effect of a maxillary occlusal device (OD) with that of sleep hygiene (SH) and progressive muscle relaxation (PMR) on sleep bruxism activity and perceived stress. This was a single-center, single-blinded, randomized controlled trial that analyzed 58 participants randomly allocated to two groups: group I — OD and group II — SH and PMR.
Male and female participants aged between 18 and 40 years with reported intense and frequent sleep bruxism by a family member or sleep partner were recruited into the study. The reported sleep bruxism was validated by a polysomnographic study. Participants in group I were fitted with an OD and those in group II were given clear instructions on sleep hygiene measures and muscle relaxation techniques. All participants were contacted biweekly to make sure that the OD was comfortable and SH and PMR instructions were being followed. Participants were followed for 1-month, 6-month, and 1-year intervals. Sleep bruxism was evaluated by electromyography of the masseter and temporalis muscles. Perceived stress was evaluated subjectively using the Perceived Stress Scale-10 questionnaire. Appropriate statistical tests were employed to assess treatment efficacy between the groups and within the same group at different time points of 1 month, 6 months, and 1 year as well as the effect of age on treatment outcome variables.
The study results showed that both treatments reduced perceived stress and sleep bruxism activity at all follow-up periods compared with those at baseline, but there was no significant difference between the groups, nullifying the effect that one treatment is superior to the other. There was also no effect of age on treatment outcomes. A significant limitation of the study was that compliance with SH and PMR interventions was entirely subjective, as the authors rightly pointed out. Utilizing some objective means of measurement of these treatment variables and a larger sample size might potentially yield valid and repeatable study results.