Baş Ağrısı Olan OUAS’lı Hastalarda Bruksizmin OUAS Şiddetine Etkisi

Yıl 2023, Cilt: 13 Sayı: 1, 95 - 102, 16.03.2023

Figen Yavlal , Sena Boncuk , Yeşim Güzey Aras

https://doi.org/10.31832/smj.1223058

Öz

AMAÇ: Sabah baş ağrıları, uyku ile ilişkili solunum bozuklukları ve Uyku Bruksizmi (UB) ile ilişkilendirilmiştir. Bu çalışmanın amacı, sabah baş ağrıları ile başvuran ve Obstrüktif Uyku Apne Sendromu (OUAS) ön tanısı olan hastalarda SB, primer baş ağrıları ve OUAS şiddeti arasındaki ilişkinin araştırılmasıdır.
GEREÇ VE YÖNTEMLER: Çalışmaya OUAS ön tanılı olan sabah baş ağrısı yaşayan ve Uluslararası Baş Ağrısı Bozuklukları Sınıflandırmasına (ICHD) göre primer baş ağrısı tanısı alan 480 hasta dahil edildi. Yaş, cinsiyet, Beden Kitle İndeksi (VKİ), baş ağrısı tipi, SB varlığı, Apne-Hipopne İndeksi'ne (AHİ) göre OUAS evresi ve hipoksi varlığı kaydedildi. Hastalar daha sonra SB (-) ve SB (+) olarak 2 gruba ayrıldı ve her iki grup baş ağrısı açısından karşılaştırıldı.
BULGULAR: Baş ağrısı tiplerine göre yapılan sınıflamada hastaların %31,5'i migren, %41,9'u gerilim tipi baş ağrısı (TTH), %2,1'i küme, %24,6'sı diğer baş ağrısı tipleri olarak sınıflandırıldı. Hastaların %76'sında SB yokken, %24'ünde SB vardı. SB olan grupta TTH oranı SB olmayan gruba göre anlamlı olarak (p<0,05) daha yüksekti. Şiddetli OUAS ve yüksek VKİ, SB grubunda, SB olmayan gruba göre anlamlı olarak daha yüksekti (p <0,05).
SONUÇ: Sabah baş ağrısı ile başvuran hastalarda uyku ile ilişkili bozuklukların ayırıcı tanısını yapmak için PSG yapılmalıdır. Uyku bruksizmi olan hastalarda obezite, şiddetli OUAS, TTH, hipoksemi sık görülür. SB, baş ağrısı ve uykuda solunum bozukluğu, spesifik neden-sonuç ilişkisi olmaksızın ortak risk faktörlerini veya ortak patofizyolojiyi paylaşır.

Anahtar Kelimeler

obstrüktif uyku apne sendromu, baş ağrısı, uyku bruksizmi

The Effect of Bruxism on the Severity of OSAS in Patients with OSAS and Headache

Öz

OBJECTIVE: Morning headaches have been associated with sleep-related breathing disorders and Sleep Bruxism (SB). The present study aims to investigate the relationship between SB, primary headaches and the severity of Obstructive Sleep Apnea Syndrome (OSAS) in patients presenting with morning headaches and a prediagnosis of OSAS.
MATERIALS AND METHODS: The study included 480 patients who prediagnosis of OSAS and morning headache complaints, and were diagnosed with primary headache according to the International Classification of Headache Disorders (ICHD). Age, gender, Body Mass Index (BMI), headache type, presence of SB, OSAS stage according to Apnea-Hypopnea Index (AHI), and presence of hypoxia were recorded. Patients were then divided into 2 groups of SB (-) and SB (+), and both groups were compared in terms of headache.
RESULTS. In the classification according to headache types, 31.5% of the patients were classified as migraine, 41.9% as tension-type headache (TTH), 2.1% as cluster, and 24.6% as other types of headache. While 76% of the patients had no SB, 24% had SB. The rate TTH was significantly (p<0.05) higher in the group with SB than in the group without SB. Severe OSAS and high BMI were significantly higher in the SB group compared to the non-SB group (p <0.05).
CONCLUSION: PSG should be performed to make a differential diagnosis of sleep-related disorders in patients presenting with a morning headache. Obesity, severe OSAS, TTH, hypoxemia are common in patients with sleep bruxism. SB, headache, and sleep-disordered breathing share common risk factors or common pathophysiology without specific cause-and-effect relationship

Anahtar Kelimeler

sleep bruxism, obstructive sleep apnea syndrome, headache

Kaynakça

• 1-Johnson, KG, Ziemba, AM, & Garb, JL. Improvement in Headaches With Continuous Positive Airway Pressure for Obstructive Sleep Apnea: A Retrospective Analysis. Headache: The Journal of Head and Face Pain, 2013; 53(2): 333–343. https://doi.org/10.1111/j.1526-4610.2012.02251.x
• 2-Neau, JP, Paquereau, J, Bailbe, M, Meurice, JC, Ingrand, P, Gil, R. Relationship Between Sleep Apnoea Syndrome, Snoring and Headaches. Cephalalgia, 2002; 22(5): 333–339.
• 3- Acar T., Acar BA. Relationship Between Alexithymia, Depression and Anxiety in Migraine and Medical Overuse Headache. Sakarya Med J, 2018; 8(3): 525-530
• 4- de Tommaso M, Fernández-de-las-Penas, C. Tension Type Headache. Current Rheumatology Reviews, 2016; 12(2): 127–139. https://doi.org/10.2174/ 1573397112666151231113625
• 5-de Tommaso M, Sciruicchio V. Migraine and Central Sensitization: Clinical Features, Main Comorbidities and Therapeutic Perspectives. Current Rheumatology Reviews, 2016; 12(2): 113–126.
• 6- de Luca Canto G, Singh, V, Bigal ME, Major PW, Flores-Mir C. Association between tension-type headache and migraine with sleep bruxism: A systematic review. Headache, 2014; 54(9): 1460–1469. https://doi.org/10.1111/head.12446
• 7- Gonçalves DAG, Camparis CM, Speciali JG, Franco AL, Castanharo S M, & Bigal M E. Temporomandibular Disorders Are Differentially Associated With Headache Diagnoses. The Clinical Journal of Pain, 2011; 27(7): 611–615.
• 8- de Holanda TA, Castagno CD, Barbon FJ, Costa YM, Goettems ML, & Boscato N. Sleep architecture and factors associated with sleep bruxism diagnosis scored by polysomnography recordings: A case-control study. Archives of Oral Biology, 2020; 112: 104685. https://doi.org/10.1016/j.archoralbio.2020.104685
• 9- Troeltzsch M, Troeltzsch M, Cronin RJ, Brodine AH, Frankenberger R, & Messlinger K. Prevalence and association of headaches, temporomandibular joint disorders, and occlusal interferences. The Journal of Prosthetic Dentistry, 2011; 105(6): 410–417.
• 10- Eıtner S, Urschıtz MS, Guenther A, Urschıtz-Duprat PM, Bohnhorst B Schlaud M, & Poets CF. Sleep problems and daytime somnolence in a German population-based sample of snoring school-aged children. Journal of Sleep Research, 2007; 16(1): 96–101. https://doi.org/10.1111/j.1365-2869.2007.00560.x
• 11- Sheldon, SH. Obstructive Sleep Apnea and Bruxism in Children. Sleep Medicine Clinics, 2010; 5(1): 163–168.
• 12- Isik U, Ersu RH, Ay P, Save D, Arman AR, Karakoc F. & Dagli E. Prevalence of Headache and its Association With Sleep Disorders in Children. Pediatric Neurology, 2007; 36(3): 146–151. https://doi.org/10.1016/j.pediatrneurol.2006.11.006
• 13- Liljeström MR, le Bell Y, Anttila P, Aromaa M, Jämsä T, Metsähonkala L, Helenius H, Viander S, Jäppilä E, Alanen P, & Sillanpää M. Headache Children with Temporomandibular Disorders have Several Types of Pain and other Symptoms. Cephalalgia, 2007; 25(11): 1054–1060. https://doi.org/10.1111/j.1468-2982.2005.00957.x
• 14 -The AASM Manual for the Scoring of Sleep and Associated Events – Rules, Terminology and Technical Specifications Version 2.5. USA, 2018
• 15- Iber C, The AASM Manual for the Scoring of Sleep and Associated Events: Rules, terminology, and technical specifications, 1st ed. Westchester, IL: American Academy of Sleep Medicine, 2007
• 16- Darien I. American Academy of Sleep Medicine (AASM) ed. International Classification of Sleep Disorders. Diagnosis and Coding Manual. Section on Sleep Related Bruxism. In American Academy of Sleep Medicine 2014; Vol. 3.ed
• 17- Freedom T, Evans RW. Headache and sleep. Headache. 2013; Sep;53(8):1358-66. doi: 10.1111/head.12178.
• 18- Almoznino G, Benoliel R, Sharav Y, Haviv Y. Sleep disorders and chronic craniofacial pain: Characteristics and management possibilities. Sleep Med Rev. 2017 Jun; 33: 39-50. doi: 10.1016/j.smrv.2016.04.005.
• 19- Mitsikostas DD, Viskos A, Papadopoulos D. Sleep and headache: the clinical relationship. Headache. 2010 Jul; 50(7): 1233-45. doi: 10.1111/j.1526-4610.2010.01729.x.
• 20- Grechi TH, Trawitzki LVV, de Felício CM, Valera FCP, Alnselmo-Lima WT. Bruxism in children with nasal obstruction. Int J Pediatr Otorhinolaryngol. 2008 Mar; 72(3): 391-6. doi: 10.1016/j.ijporl.2007.11.014.
• 21- Ohayon MM, Roth T. What are the contributing factors for insomnia in the general population? J Psychosom Res. 2001 Dec; 51(6): 745-55. doi: 10.1016/s0022-3999(01)00285-9.