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Complicações cardiovasculares associadas ao bruxismo do sono
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Abstract(s)
Em 2013, segundo Lobbezoo et al. obteve-se um consenso sobre uma definição de bruxismo, assim é a atividade muscular mastigatória repetitiva caracterizada por apertar ou ranger dos dentes e/ou por contrair ou empurrar da mandíbula, e foi especificado como bruxismo do sono ou bruxismo de vígilia, dependendo das manifestações circadianas distintas (Lobbezoo et al., 2018).
O bruxismo do sono foi referido em 2005 pela International Classification of Sleep Disorders, como atividade oral relacionada com o mesmo, caracterizada pelo ranger e apertar dos dentes durante o sono e, associado a microdespertares (Lavigne et al., 2008).
No Consenso de 2018, salienta que o bruxismo pode estar associado a determinadas condições específicas, como é o Síndrome da Apneia Obstrutiva do Sono (SAOS) e/ou outras alterações do sono (insónia e estados de hiper vigília) ou a sintomas como a xerostomia, sem que haja necessariamente uma relação causa-efeito (Lobbezoo et al., 2018).
Uma disfunção do sistema nervoso autónomo pode estar relacionada a uma excitação durante o sono sendo causa subjacente das implicações cardiovasculares do bruxismo do sono (Zrabkowska et al., 2021).
O objetivo principal desta revisão é investigar nos artigos publicados uma possível correlação entre as doenças cardiovasculares e o bruxismo do sono. Colocando-se questões como: São os pacientes com diagnóstico de bruxismo do sono com risco cardiovascular aumentado em comparação a pacientes sem bruxismo? Ou haverá necessidade de desenvolver uma nova abordagem para as consequências do bruxismo do sono?
Na maioria da literatura disponível foi possível observar através de evidências um mecanismo patológico que liga o bruxismo do sono com um aumento da atividade simpática e consequentemente a um aumento da variabilidade da frequência cardíaca, do processo inflamatório, do stress oxidativo, da remodelação endotelial e dos distúrbios hormonais, levando a uma hipertensão arterial assim como a possibilidade de outras complicações cardiovasculares (Zrabkowska et al.,2021).
According to Lobbezoo et al. (2018), a consensus was reached on a definition of bruxism in 2013 and it has since been classified as either sleep bruxism or awake bruxism depending on the distinct circadian manifestations. Bruxism is defined as repetitive masticatory muscle activity that is characterized by teeth clenching or grinding and/or "bracing" or thrusting of the jaw. The International Classification of Sleep Disorders first mentioned sleep bruxism in 2005 as a related oral activity characterized by teeth grinding and clenching during sleep coupled with microarousals (Lavigne et al., 2008). The 2018 Consensus notes that there may not always be a cause-and-effect relationship between bruxism and certain specific conditions, such as Obstructive Sleep Apnea Syndrome (OSAS) and/or other sleep disorders (insomnia and hypervigil states), or symptoms like xerostomia. (Lobbezoo et al., 2018). The cardiovascular effects of sleep bruxism are due to an autonomic nerve system malfunction, which may be connected to arousal during sleep (Zrabkowska et al., 2021). The study's main goal is to look at any correlations between sleep bruxism and heart disease. By posing queries like: Do people with sleep bruxism have an increased cardiovascular risk compared to individuals without it? Or is an entirely new approach to deal with the effects of sleep bruxism required?Or is there a need to develop a new approach to the consequences of sleep bruxism? A pathological mechanism linking sleep bruxism with an increase in sympathetic activity and, consequently, an increase in heart rate variability, the inflammatory process, oxidative stress, endothelial remodeling, and hormonal disorders, leading to arterial hypertension as well as the potential for other cardiovascular complications, has been observed through evidence in the majority of the available literature and synthesis (Zrabkowska et al., 2021).
According to Lobbezoo et al. (2018), a consensus was reached on a definition of bruxism in 2013 and it has since been classified as either sleep bruxism or awake bruxism depending on the distinct circadian manifestations. Bruxism is defined as repetitive masticatory muscle activity that is characterized by teeth clenching or grinding and/or "bracing" or thrusting of the jaw. The International Classification of Sleep Disorders first mentioned sleep bruxism in 2005 as a related oral activity characterized by teeth grinding and clenching during sleep coupled with microarousals (Lavigne et al., 2008). The 2018 Consensus notes that there may not always be a cause-and-effect relationship between bruxism and certain specific conditions, such as Obstructive Sleep Apnea Syndrome (OSAS) and/or other sleep disorders (insomnia and hypervigil states), or symptoms like xerostomia. (Lobbezoo et al., 2018). The cardiovascular effects of sleep bruxism are due to an autonomic nerve system malfunction, which may be connected to arousal during sleep (Zrabkowska et al., 2021). The study's main goal is to look at any correlations between sleep bruxism and heart disease. By posing queries like: Do people with sleep bruxism have an increased cardiovascular risk compared to individuals without it? Or is an entirely new approach to deal with the effects of sleep bruxism required?Or is there a need to develop a new approach to the consequences of sleep bruxism? A pathological mechanism linking sleep bruxism with an increase in sympathetic activity and, consequently, an increase in heart rate variability, the inflammatory process, oxidative stress, endothelial remodeling, and hormonal disorders, leading to arterial hypertension as well as the potential for other cardiovascular complications, has been observed through evidence in the majority of the available literature and synthesis (Zrabkowska et al., 2021).
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Bruxismo Bruxismo do sono Risco cardiovascular Doenças cardiovasculares