CMT CMT Sleep Disorders & Bruxism 1 — Questions and Answers
Question 1: What is the apnea-hypopnea index (AHI) and what does it measure?
- Tongue thrust frequency per hour of sleep
- The number of apnea and hypopnea events per hour of sleep (Correct answer)
- Oxygen desaturation percentage during sleep
- Duration of REM sleep per night
Correct answer: The number of apnea and hypopnea events per hour of sleep
The AHI measures the average number of apnea (complete cessation) and hypopnea (partial obstruction) events per hour of sleep to classify OSA severity.
Question 2: Myofunctional therapy for sleep-disordered breathing is considered MOST effective for which patient population?
- Adults with severe OSA requiring high-pressure CPAP
- Adults and children with mild to moderate OSA and myofunctional dysfunction (Correct answer)
- Patients with central sleep apnea
- Patients whose OSA is purely positional
Correct answer: Adults and children with mild to moderate OSA and myofunctional dysfunction
Research supports myofunctional therapy primarily for mild to moderate OSA patients with identifiable oropharyngeal muscle dysfunction contributing to airway collapse.
Question 3: Sleep bruxism is characterized by which orofacial activity during sleep?
- Involuntary tongue thrusting
- Rhythmic masticatory muscle activity (RMMA) causing tooth grinding or clenching (Correct answer)
- Soft palate vibration causing snoring
- Jaw dropping open during deep sleep
Correct answer: Rhythmic masticatory muscle activity (RMMA) causing tooth grinding or clenching
Sleep bruxism is defined by rhythmic masticatory muscle activity (RMMA) during sleep, manifesting as tooth grinding (bruxing) or clenching, often associated with micro-arousals.
Question 4: What is the connection between sleep bruxism and sleep-disordered breathing?
- They are unrelated conditions
- Bruxism episodes often follow micro-arousals triggered by airway obstruction events (Correct answer)
- Bruxism causes sleep apnea
- Sleep apnea causes bruxism through CPAP use
Correct answer: Bruxism episodes often follow micro-arousals triggered by airway obstruction events
Current evidence suggests bruxism episodes are frequently preceded by micro-arousals associated with airway obstruction, suggesting a protective mechanism to restore airway patency.
Question 5: A patient with sleep bruxism is referred to myofunctional therapy. Which component of therapy directly addresses the muscular contributors to bruxism?
- Nasal breathing retraining and tongue posture exercises (Correct answer)
- Bite splint fabrication
- Sleep hygiene counseling
- Dietary modification
Correct answer: Nasal breathing retraining and tongue posture exercises
Restoring nasal breathing, correct tongue posture, and reducing masticatory muscle hypertonicity through orofacial exercises directly targets the myofunctional contributors to sleep bruxism.
Question 6: Which symptom is NOT a classic daytime consequence of untreated obstructive sleep apnea?
- Excessive daytime sleepiness
- Morning headaches
- Increased salivation (Correct answer)
- Difficulty concentrating
Correct answer: Increased salivation
Increased salivation is not a typical consequence of OSA; instead, patients commonly experience dry mouth due to nocturnal mouth breathing and excessive daytime sleepiness, headaches, and cognitive impairment.
CMT CMT Sleep Disorders & Bruxism 1
What is the apnea-hypopnea index (AHI) and what does it measure?