In many OSA patients (30-40%), you will find that they also suffer from Sleep Bruxism. They will have the characteristic dental findings (abfraction lesions, excessively worn teeth, etc.) as well as muscle pain on palpation along with their OSA symptoms.
Treating these patients must accommodate both disorders or there is a high risk of treatment failure (either due to patient abandonment from pain or appliance failure under the excessive loading of Sleep Bruxism).
The records are the same, dental casts/digital scans and a protrusive bite registration.
Treat the Sleep Bruxism first. Start at the 75% advancement until their jaws have settled down. This position will effectively treat many OSA and snoring patients without any changes.
If necessary, advance very slowly to alleviate the OSA symptoms, 1-2 turns pre week, to prevent relapse of the SB.
Remember to re-measure the patient’s range of motion and record, every appointment. Do not go less than 75% for these patients or you risk re-activating the Sleep Bruxism!
Use the same assessment as with SB for unilateral jaw pain. With a little extra care you can very significantly improve the quality of life for these patients, by addressing their OSA symptoms and their Sleep Bruxism symptoms.
As well, a home exercise program is very helpful for these patients. The following link has some useful ones:
