Effect of occlusal appliances on the sleep of individuals with bruxism: A systematic review and meta-analyses.

Objective: This systematic review determined whether occlusal appliance use influences the sleep of individuals with sleep bruxism.

Material and methods: Six databases and the gray literature were searched to identify randomized and non-randomized clinical trials comparing slow wave sleep and sleep quality of sleep bruxers before and after occlusal appliance use. The Risk of Bias was assessed using Cochrane tools and Meta-analyses were performed to compare data. The Certainty of the evidence was evaluated by Grading of Recommendations Assessment, Development, and Evaluation approach.

Results: Two randomized and eight non-randomized studies were included. Meta-analyses indicated that soft and hard appliances influenced the slow-wave sleep and sleep quality of sleep bruxers, as determined by polysomnography (Z = 5.58; p < .001), the Pittsburgh Sleep Quality Index (Z = 3.45; p < .001), and the Sleep Assessment Questionnaire (Z = 48.1; p < .001).

Conclusion: Occlusal appliance use significantly impacts slow-wave sleep and sleep quality in sleep bruxism individuals, regardless of appliance design or material.