Titre du document / Document title

The effect of 2 sympatholytic medications-propranolol and clonidine-on sleep bruxism : Experimental randomized controlled studies

Auteur(s) / Author(s)

HUYNH Nelly ^{(1 2)} ; LAVIGNE Gilles J. ^{(1 2)} ; LANFRANCHI Paola A. ^{(1 2)} ; MONTPLAISIR Jacques Y. ^{(1 2)} ; DE CHAMPLAIN Jacques ^{(1 3)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Facultés de médecine et de médecine dentaire, Université de Montréal, Québec, CANADA
⁽²⁾ Centre d'étude du sommeil, Hôpital du Sacré-Coeur de Montréal, Québec, CANADA
⁽³⁾ Institut de recherche clinique de Montréal, Québec, CANADA

Résumé / Abstract

Study Objective: To examine whether 2 sympatholytic medications decrease sleep bruxism and prevent the rise in sympathetic activity preceding the onset of sleep bruxism: propranolol, a nonselective adrenergic β-blocker, and clonidine, a selective α₂-agonist. Design: Experimental randomized controlled crossover studies with placebo and active treatments (propranolol 120 mg; clonidine 0.3 mg). Setting: Hospital-based sleep research laboratory. Patients: Twenty-five subjects with a history and diagnosis of SLEEP BRUXISM (11 men, 14 women; age range, 21 to 31 years). Intervention: Polygraphic study Measurements and Results: Polygraphic sleep laboratory recordings were done for 4 nights: the first night was habitation, the second, sleep bruxism diagnosis; and 3 and 4 were study nights. The sleep bruxism index was estimated using masseter muscle activity. Heart rate variability was estimated with spectral analysis of RR intervals. Sleep and sleep bruxism variables were not significantly influenced by propranolol. A reduction of the mean RR intervals and of the sympathetic dominance (p <.05) was seen. Under clonidine, duration of sleep stage 2 was prolonged, whereas REM sleep was suppressed in 14 of 16 subjects with sleep bruxism. The sleep bruxism index was reduced by 61% (p <.05). Under clonidine, a reduction in heart rate and sympathetic dominance was observed in stable sleep and in the minute preceding the onset of sleep bruxism (p <.05). Conclusion: Although propranolol did not affect sleep bruxism, clonidine decreased sympathetic tone in the minute preceding the onset of sleep bruxism, thus reducing sleep bruxism by preventing the sequence of autonomic to motor activation of sleep bruxism. This further supports the role of sympathetic activity in the pathophysiology of sleep bruxism. Because morning hypotension was seen in 19% of patients, further dose-dependant research is required to assess the safety of clonidine for the management of sleep bruxism.

Revue / Journal Title

Sleep   ISSN 0161-8105   CODEN SLEED6 

Source / Source

2006, vol. 29, n^o3, pp. 307-316 [10 page(s) (article)] (48 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Academy of Sleep Medicine, Rochester, MN, ETATS-UNIS  (1978) (Revue)

Mots-clés anglais / English Keywords

Autonomic nervous system ; Stomatology ; Sleep wake cycle ; α-Adrenergic receptor agonist ; Imidazoline receptor ; α2-Adrenergic receptor ; Imidazole derivatives ; Agonist ; β-Adrenergic receptor ; Beta blocking agent ; Antagonist ; Human ; Sympathetic nervous system ; Randomized design ; Experimental study ; Bruxism ; Sleep ; Clonidine ; Propranolol ; Sympatholytic ;

Mots-clés français / French Keywords

Système nerveux autonome ; Stomatologie ; Cycle veille sommeil ; Stimulant α-adrénergique ; Récepteur imidazoline ; Récepteur α2-adrénergique ; Imidazole dérivé ; Agoniste ; Récepteur β-adrénergique ; Bloquant β-adrénergique ; Antagoniste ; Homme ; Système nerveux sympathique ; Plan randomisé ; Etude expérimentale ; Bruxomanie ; Sommeil ; Clonidine ; Propranolol ; Sympatholytique ;

Mots-clés espagnols / Spanish Keywords

Sistema nervioso autónomo ; Estomatología ; Ciclo sueño vigilia ; Estimulante α-adrenérgico ; Receptor imidazolina ; Receptor α2-adrenérgico ; Imidazol derivado ; Agonista ; Receptor β-adrenérgico ; Bloqueador β-adrenérgico ; Antagonista ; Hombre ; Sistema nervioso simpático ; Plan aleatorizado ; Estudio experimental ; Bruxismo ; Sueño ; Clonidina ; Propranolol ; Simpaticolítico ;

Localisation / Location

INIST-CNRS, Cote INIST : 18084, 35400011519288.0060