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Sleep Breath. 2019 Aug 12. doi: 10.1007/s11325-019-01915-2. [Epub ahead of print]

Polysomnographic scoring of sleep bruxism events is accurate even in the absence of video recording but unreliable with EMG-only setups.

Author information

1
Department of Applied Physics, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland. tomi.miettinen@uef.fi.
2
Institute of Dentistry, University of Eastern Finland, Kuopio, Finland. tomi.miettinen@uef.fi.
3
Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland. tomi.miettinen@uef.fi.
4
Department of Applied Physics, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland.
5
Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
6
Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
7
Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.
8
Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.
9
Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
10
Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.

Abstract

PURPOSE:

To determine the accuracy of scoring masticatory muscle activity (MMA) events in seven different polysomnography (PSG) setups.

METHODS:

Nineteen volunteers (13 females, 6 males, age 31.1 ± 12.9 years, 12 self-proclaimed bruxers) attended one-night PSG recording, supplemented with audio, video, and a separate frontal electroencephalography electrode set (FES). The same examiner scored the MMA events with seven different setups, with varying number of channels available: (1) one, (2) two, and (3) four EMG channels, (4) PSG without audio or video (PSG-N), (5) home PSG with FES and audio (FES-A), (6) PSG with audio (PSG-A), and (7) PSG with audio and video (PSG-AV). A subset (n = 10) of recordings was scored twice to determine intra-scorer reliability. MMA indices and accuracy of scoring the events in different setups were compared against PSG-AV.

RESULTS:

The intra-class correlation coefficient (ICC) between PSG-AV and PSG-A was high (0.940, p < 0.001) as well as for FES-A (0.927, p < 0.001), whereas for PSG-N, it was lower (0.835, p < 0.001); for setups with only EMG channels, coefficients were very low (ICC < 0.100 for all). Intra-examiner reliability was high (ICC > 0.939 for all setups), with the exception of PSG-N (ICC = 0.764, p = 0.002). When comparing against the MMA events scored in PSG-AV, the sensitivity of MMA event recognition for PSG-A was 78.5% and specificity 95.5%, which were substantially higher than sensitivity (52.0%) and specificity (87.2%) of PSG-N.

CONCLUSIONS:

MMA event scoring accuracy with PSG-A or FES-A is almost comparable to PSG-AV. Since precise event recognition is essential for accurate MMA scoring, it is evident that one cannot rely exclusively on EMG.

KEYWORDS:

Audio; Electroencephalography; Electromyography; Masticatory muscle activity; Sleep bruxism; Video

PMID:
31402440
DOI:
10.1007/s11325-019-01915-2

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