Sleep Quality and Comfort Reported by Sleep Bruxism Individuals Wearing the Occlusal Splint and Mandibular Advancement Splint: Revisiting Two Crossover Studies

Purpose: To assess (1) whether an occlusal splint (OS) or mandibular advancement splint (MAS) allowed better sleep quality and was more comfortable in individuals with sleep bruxism (SB); and (2) the relationship between sleep quality, comfort, and reduction in RMMA related to SB. Materials and Methods: Polysomnographic data from 21 SB subjects (mean & PLUSMN; SD age 25.6 & PLUSMN; 4.5 years) collected in two previous studies were compared. Morning self-reports on sleep quality and comfort of the oral device, polysomnographic data, and RMMA index data from no-device nights were compared to nights using an OS or MAS. The reduction ratio of the RMMA index was calculated for both devices. A responder to the oral device was identified when the RMMA index was less than and when it showed a reduction of at least 50% from the no-device control night. Results: Self-reports for sleep quality and comfort of the oral device showed a mild advantage of the OS when compared to the MAS (r2 0.47, r2 = 0.32; P & LE; .01). In responders, the MAS induced a greater reduction in the RMMA index (P = .03) than the OS. Conclusions: In the short term, the comfort of the oral device seemed to influence sleep quality in SB individuals. However, despite the slightly higher degree of comfort offered by the OS, the MAS induced a greater effect on the RMMA index. Int J Prosthodont 2023;36:138-147. doi: 10.11607/ijp.7525