Morning Awakening With Pain in Sleep Bruxers with Craniomandibular Disorders and Concomitant Use of Selective Serotonin Reuptake Inhibitors (Ssris): A Intra-Group Comparison Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Introduction: Subjects with sleep bruxing behavior may present with morning awakening with pain in multiple anatomic areas. Awakening with pain may be influenced to a certain extent by previous or current use of Selective serotonin reuptake inhibitors. Aim: Evaluate frequency of selective serotonin reuptake inhibitors in sleep bruxers with craniomandibular disorders, assess frequency of anatomic areas reported with pain on awakening in the morning. Methods: Clinical examination, palpation of masticatory muscles and temporomandibular joints, use of questionnaires and self-report to gather data in 53 subjects currently using selective serotonin reuptake inhibitors, 31 subjects with history of past SSRIs use, 21 subjects who reported that used or were using another antidepressant type and 39 who never used antidepressants. Data from all these subjects were reviewed retrospectively. Results: The frequency of current use of selective serotonin reuptake inhibitors was about 53=36,8% and 31=21,5% of bruxers and craniomandibular disorders subjects reported past SSRIs use. 21=14,5% of all bruxers reported past or current use of another antidepressant type and 39=27% of the sample reported that never used antidepressants. In those subjects reporting current Selective serotonin reuptake inhibitors use, the most common sites with morning awakening with pain were the head (54,7%), cervical area (50,9%), temporomandibular joints (43,4%), face (35,8%), and teeth (32,1%). The frequency of morning awakening with pain in these anatomic areas was higher in the “current use of SSRIs” subgroup as compared with the control group that never used any antidepressant. The mean frequency of anatomic areas with pain on awakening in the morning was higher in the “have used SSRIs” subgroup as compared with the “never used AD” subgroup and the difference was statistically significant (Kruskal-Wallis statistics p<0.05). Mean painful areas on awakening in the morning were about 2, 9 (subgroup using SSRIs); 2, 6 (Have used SSRIs subgroup); 2.1 (used/using another antidepressant subgroup) and 1,6 (never used antidepressant subgroup). The difference was statistically significant only when the subgroups “Have used SSRIs and “Never used antidepressant”, were contrasted (Kruskal-Wallis´statistics p<0.05). Conclusions: Because higher frequencies of awakening with headache, facial pain, and dental pain were reported by subjects who had used or were using SSRIs as compared with the subgroup that never used SSRIs, such antidepressants may play a role increasing loading on the masticatory structures. However, further studies are needing to substantiate findings in the current investigation.
Authors and Affiliations
Marcus Sobreira Peixoto, Bruno R. Simião, Zeila C. Santos, Douglas Oliveira Andrade, Mauricio Augusto Fregonesi, Daniella Mateus dos Santos, Omar Franklin Molina
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