{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:57:52Z","timestamp":1784869072938,"version":"3.55.0"},"reference-count":50,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T00:00:00Z","timestamp":1719619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Tension-type headache (TTH) is the most common primary headache. Obstructive sleep apnea (OSA) and sleep bruxism (SB) are two of the most common sleep disorders; however, the relationship between TTH, OSA, and SB has not been conclusively proved in the literature. The objective of our study was to estimate potential associations with OSA and SB in TTH subjects. Methods: 108 adult individuals who underwent polysomnography (vPSG) were included, and the group was divided into two subgroups: TTH (n = 34) and control (n = 74). The International Classification of Headache Disorders (ICHD-3) guidelines were used to diagnose TTH. OSA and SB diagnoses were based on vPSG examination with electromyographic (EMG) recordings and the American Academy of Sleep Medicine (AASM) criteria. The results were analyzed, where p &lt; 0.05 was considered to be statistically significant. Results: In the TTH group, the incidence of SB was more than two times lower than the control (OR = 0.41, 95% CI: 0.17\u20130.96, p &lt; 0.05). However, the incidence of severe SB (BEI &gt; 4) was similar in the TTH and control groups (OR = 0.54, 95% CI: 0.21\u20131.35, p &gt; 0.05). Additionally, phasic and tonic SB episodes were less frequent in the TTH group compared to the controls (p &lt; 0.05). The mean apnea\u2013hypopnea index (AHI) was not significantly different between the TTH and control groups (p &gt; 0.05). The sleep architecture and respiratory disturbances did not differ between the examined groups (p &gt; 0.05). Conclusions: SB is not a risk factor for TTH. Moreover, severe SB is not connected with TTH. OSA is not a risk factor for TTH. Sleep quality did not differ between both groups during PSG; therefore, TTH may not change sleep structure. The mechanism of these findings is still unclear, and further studies should explain in detail the association between TTH and OSA.<\/jats:p>","DOI":"10.3390\/jcm13133835","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T09:06:07Z","timestamp":1719824767000},"page":"3835","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Sleep Bruxism and Obstructive Sleep Apnea Are Not Risk Factors for Tension-Type Headache (TTH): A Polysomnographic Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Bart\u0142omiej","family":"B\u0142aszczyk","sequence":"first","affiliation":[{"name":"Student Research Club No K133, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1283-8460","authenticated-orcid":false,"given":"Helena","family":"Martynowicz","sequence":"additional","affiliation":[{"name":"Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Niemiec","sequence":"additional","affiliation":[{"name":"Student Research Club No K133, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub","family":"Przegra\u0142ek","sequence":"additional","affiliation":[{"name":"Student Research Club No K133, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martyna","family":"Staszkiewicz","sequence":"additional","affiliation":[{"name":"Student Research Club No K133, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Wojakowska","sequence":"additional","affiliation":[{"name":"Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u0142awomir","family":"Budrewicz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9074-2803","authenticated-orcid":false,"given":"Marta","family":"Waliszewska-Pros\u00f3\u0142","sequence":"additional","affiliation":[{"name":"Department of Neurology, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,29]]},"reference":[{"key":"ref_1","first-page":"537","article-title":"Manual Therapy in Adults with Tension-Type Headache: A Systematic Review","volume":"36","year":"2021","journal-title":"Neurologia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/joor.12663","article-title":"International Consensus on the Assessment of Bruxism: Report of a Work in Progress","volume":"45","author":"Lobbezoo","year":"2018","journal-title":"J. Oral Rehabil."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s10194-023-01700-3","article-title":"The World Health Organization Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders and the Headache Revolution: From Headache Burden to a Global Action Plan for Headache Disorders","volume":"25","author":"Leonardi","year":"2024","journal-title":"J. Headache Pain"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41572-021-00257-2","article-title":"Tension-Type Headache","volume":"7","author":"Ashina","year":"2021","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/s10194-023-01653-7","article-title":"Relationship between Alcohol and Primary Headaches: A Systematic Review and Meta-Analysis","volume":"24","author":"Budrewicz","year":"2023","journal-title":"J. Headache Pain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.mcna.2018.10.003","article-title":"Migraine and Tension-Type Headache: Diagnosis and Treatment","volume":"103","author":"Burch","year":"2019","journal-title":"Med. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s10194-022-01402-2","article-title":"The Global Prevalence of Headache: An Update, with Analysis of the Influences of Methodological Factors on Prevalence Estimates","volume":"23","author":"Stovner","year":"2022","journal-title":"J. Headache Pain"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Headache Classification Committee of the International Headache Society (IHS) (2018). The International Classification of Headache Disorders, 3rd Edition. Cephalalgia, 38, 1\u2013211.","DOI":"10.1177\/0333102417738202"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s10194-023-01614-0","article-title":"Debate: Differences and Similarities between Tension-Type Headache and Migraine","volume":"24","author":"Onan","year":"2023","journal-title":"J. Headache Pain"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Repiso-Guarde\u00f1o, A., Moreno-Morales, N., Armenta-Pend\u00f3n, M.A., Rodr\u00edguez-Mart\u00ednez, M.d.C., Pino-Lozano, R., and Armenta-Peinado, J.A. (2023). Physical Therapy in Tension-Type Headache: A Systematic Review of Randomized Controlled Trials. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20054466"},{"key":"ref_11","unstructured":"Shah, N., and Hameed, S. (2024). Muscle Contraction Tension Headache. StatPearls, StatPearls Publishing."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101889","DOI":"10.1016\/j.smrv.2023.101889","article-title":"Prevalence of Headaches and Their Relationship with Obstructive Sleep Apnea (OSA)\u2014Systematic Review and Meta-Analysis","volume":"73","author":"Martynowicz","year":"2024","journal-title":"Sleep Med. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1002\/alr.23079","article-title":"International Consensus Statement on Obstructive Sleep Apnea","volume":"13","author":"Chang","year":"2023","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1001\/jama.2020.3514","article-title":"Diagnosis and Management of Obstructive Sleep Apnea: A Review","volume":"323","author":"Gottlieb","year":"2020","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1007\/s11325-023-02810-7","article-title":"Worldwide Prevalence and Associated Risk Factors of Obstructive Sleep Apnea: A Meta-Analysis and Meta-Regression","volume":"27","author":"Martins","year":"2023","journal-title":"Sleep Breath"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40248-019-0172-9","article-title":"Obstructive Sleep Apnea and Comorbidities: A Dangerous Liaison","volume":"14","author":"Bonsignore","year":"2019","journal-title":"Multidiscip. Respir. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S2213-2600(12)70051-6","article-title":"Obstructive Sleep Apnoea and Cardiovascular Disease","volume":"1","year":"2013","journal-title":"Lancet Respir. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12931-020-1284-7","article-title":"Cardiometabolic Comorbidities in Obstructive Sleep Apnea Patients Are Related to Disease Severity, Nocturnal Hypoxemia, and Decreased Sleep Quality","volume":"21","author":"Andreozzi","year":"2020","journal-title":"Respir. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"210256","DOI":"10.1183\/16000617.0256-2021","article-title":"Bidirectional Relationships of Comorbidity with Obstructive Sleep Apnoea","volume":"31","author":"Gleeson","year":"2022","journal-title":"Eur. Respir. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Borsoi, L., Armeni, P., Donin, G., Costa, F., and Ferini-Strambi, L. (2022). The Invisible Costs of Obstructive Sleep Apnea (OSA): Systematic Review and Cost-of-Illness Analysis. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0268677"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.wjorl.2015.08.001","article-title":"Clinical Consequences and Economic Costs of Untreated Obstructive Sleep Apnea Syndrome","volume":"1","author":"Knauert","year":"2015","journal-title":"World J. Otorhinolaryngol. Head Neck Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1111\/joor.12801","article-title":"Bruxism: An Umbrella Review of Systematic Reviews","volume":"46","author":"Melo","year":"2019","journal-title":"J. Oral Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/08869634.2020.1716466","article-title":"A Polysomnographic Study on the Relationship between Sleep Bruxism Intensity and Sleep Quality","volume":"40","author":"Smardz","year":"2022","journal-title":"CRANIO"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1038\/sj.bdj.2018.757","article-title":"Sleep Bruxism: An Overview for Clinicians","volume":"225","author":"Beddis","year":"2018","journal-title":"Br. Dent. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/joor.13411","article-title":"Standardised Tool for the Assessment of Bruxism","volume":"51","author":"Manfredini","year":"2024","journal-title":"J. Oral Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.jdent.2018.07.005","article-title":"Association between Bruxism and Symptomatic Gastroesophageal Reflux Disease: A Case-Control Study","volume":"77","author":"Li","year":"2018","journal-title":"J. Dent."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1111\/joor.12697","article-title":"Parkinson\u2019s Disease, Temporomandibular Disorders and Bruxism: A Pilot Study","volume":"45","author":"Verhoeff","year":"2018","journal-title":"J. Oral Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"409","DOI":"10.5664\/jcsm.8218","article-title":"Sleep-Related Movement Disorders in a Population of Patients with Epilepsy: Prevalence and Impact of Restless Legs Syndrome and Sleep Bruxism","volume":"16","author":"Khachatryan","year":"2020","journal-title":"J. Clin. Sleep Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.sleep.2021.11.008","article-title":"Associations between Sleep Bruxism and Other Sleep-Related Disorders in Adults: A Systematic Review","volume":"89","author":"Kuang","year":"2022","journal-title":"Sleep Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1179\/2151090314Y.0000000025","article-title":"Sleep Bruxism Associated with Obstructive Sleep Apnea Syndrome in Children","volume":"33","author":"Ferreira","year":"2015","journal-title":"CRANIO"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s10194-015-0517-5","article-title":"Tension-Type Headache Associated with Obstructive Sleep Apnea: A Nationwide Population-Based Study","volume":"16","author":"Chiu","year":"2015","journal-title":"J. Headache Pain"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s10194-010-0265-5","article-title":"Tension-Type Headache and Sleep Apnea in the General Population","volume":"12","author":"Kristiansen","year":"2011","journal-title":"J. Headache Pain"},{"key":"ref_33","first-page":"14","article-title":"Temporomandibular Disorders, Sleep Bruxism, and Primary Headaches Are Mutually Associated","volume":"27","author":"Fernandes","year":"2013","journal-title":"J. Orofac. Pain"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"129","DOI":"10.11607\/ofph.2745","article-title":"Association Between Primary Headache and Bruxism: An Updated Systematic Review","volume":"35","author":"Polmann","year":"2021","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"597","DOI":"10.5664\/jcsm.2172","article-title":"Rules for Scoring Respiratory Events in Sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events","volume":"8","author":"Berry","year":"2012","journal-title":"J. Clin. Sleep Med."},{"key":"ref_36","unstructured":"American Academy of Sleep Medicine (2014). International Classification of Sleep Disorders, 3rd ed, American Academy of Sleep Medicine."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1590\/0004-282x20190069","article-title":"Association of Bruxism and Anxiety Symptoms among Military Firefighters with Frequent Episodic Tension Type Headache and Temporomandibular Disorders","volume":"77","author":"Wagner","year":"2019","journal-title":"Arq. Neuro-Psiquiatr."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Ohlmann, B., Waldecker, M., Leckel, M., B\u00f6micke, W., Behnisch, R., Rammelsberg, P., and Schmitter, M. (2020). Correlations between Sleep Bruxism and Temporomandibular Disorders. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020611"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Straburzy\u0144ski, M., Waliszewska-Pros\u00f3\u0142, M., Nowaczewska, M., Czapinska-Ciepiela, E.K., Gryglas-Dworak, A., and Budrewicz, S. (2024). Prevalence of cranial autonomic symptoms in frequent episodic tension-type headache: A post hoc analysis of the cross-sectional Migraine in Poland study. Dent. Med. Probl.","DOI":"10.17219\/dmp\/175611"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.pediatrneurol.2008.03.007","article-title":"Polysomnographic Findings in Children with Headaches","volume":"39","author":"Vendrame","year":"2008","journal-title":"Pediatr. Neurol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/joor.12069","article-title":"Prevalence of Sleep Bruxism in Children: A Systematic Review of the Literature","volume":"40","author":"Manfredini","year":"2013","journal-title":"J. Oral Rehabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"521","DOI":"10.5664\/jcsm.8940","article-title":"Diagnostic Performance of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea in Different Ethnic Groups","volume":"17","author":"Waseem","year":"2021","journal-title":"J. Clin. Sleep Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e211009","DOI":"10.1001\/jamanetworkopen.2021.1009","article-title":"Use and Performance of the STOP-Bang Questionnaire for Obstructive Sleep Apnea Screening Across Geographic Regions: A Systematic Review and Meta-Analysis","volume":"4","author":"Pivetta","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1589\/jpts.29.1889","article-title":"The Relationship between Bruxism, Sleep Quality, and Headaches in Schoolchildren","volume":"29","author":"Bortoletto","year":"2017","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Martynowicz, H., Smardz, J., Michalek-Zrabkowska, M., Gac, P., Poreba, R., Wojakowska, A., Mazur, G., and Wieckiewicz, M. (2019). Evaluation of Relationship Between Sleep Bruxism and Headache Impact Test-6 (HIT-6) Scores: A Polysomnographic Study. Front. Neurol., 10.","DOI":"10.3389\/fneur.2019.00487"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/j.1526-4610.2012.02251.x","article-title":"Improvement in Headaches with Continuous Positive Airway Pressure for Obstructive Sleep Apnea: A Retrospective Analysis","volume":"53","author":"Johnson","year":"2013","journal-title":"Headache"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"566","DOI":"10.3988\/jcn.2018.14.4.566","article-title":"Insufficient Sleep in Tension-Type Headache: A Population Study","volume":"14","author":"Oh","year":"2018","journal-title":"J. Clin. Neurol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4103\/aam.aam_241_21","article-title":"Quality of Sleep and Disability Associated with Headache: Migraine versus Tension-Type Headache: A Comparative Study","volume":"22","author":"Singh","year":"2023","journal-title":"Ann. Afr. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/ane.12237","article-title":"Sleep Quality and Arousal in Migraine and Tension-Type Headache: The Headache-Sleep Study","volume":"129","author":"Hagen","year":"2014","journal-title":"Acta Neurol. Scand."},{"key":"ref_50","first-page":"S72","article-title":"Study of Sleep Disorders and Polysomnographic Evaluation among Primary Chronic Daily Headache Patients","volume":"7","author":"Verma","year":"2016","journal-title":"J. Neurosci. Rural. Pract."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3835\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:07:51Z","timestamp":1760108871000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,29]]},"references-count":50,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jcm13133835"],"URL":"https:\/\/doi.org\/10.3390\/jcm13133835","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,29]]}}}