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      Patient‐based experiences with the use of an ambulatory electromyographic device for the assessment of masticatory muscle activity during sleep

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          Abstract

          Background

          It is important to know how easy or difficult it is to use an ambulatory electromyographic (EMG) device for sleep bruxism assessment, and how this might affect its future utilisation.

          Objective

          To explore the experience of individuals using an EMG device that pairs with a smartphone app, in order to detect factors that could facilitate and/or hamper its utilisation in future scientific research.

          Methods

          Fifteen adults were recruited in the Orofacial Pain and Dysfunction Clinic of the Academic Centre for Dentistry Amsterdam (ACTA). Overnight recordings were performed in the home setting during one week. Time investment, feelings and thoughts, encountered difficulties and reasons for not using the device were assessed in a diary through open‐ended questions and 5‐point Likert scales. Content analysis of textual data was performed, and descriptives of quantitative data were calculated.

          Results

          Time investment was low (mean 10.2 minutes in the clinic, and 1.9 minutes per recording at home). Quantitative data showed an overall good experience (median of 4). Qualitative diary data showed that the desire to gain insight into one's masticatory muscle activity formed the main motivation to use the device. Device detachment and difficulty in using the app were the most prominent negative experiences.

          Conclusion

          The EMG device was well accepted for multiple overnight recordings. Curiosity for gaining insight into muscle activity was the most important factor that facilitated its use, and the app addressed this need. Device detachment and difficulties in using the app were the main factors that hampered its use.

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          Most cited references29

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          The Use of Smartphones for Health Research.

          Because of their growing popularity and functionality, smartphones are increasingly valuable potential tools for health and medical research. Using ResearchKit, Apple's open-source platform to build applications ("apps") for smartphone research, collaborators have developed apps for researching asthma, breast cancer, cardiovascular disease, type 2 diabetes, and Parkinson disease. These research apps enhance widespread participation by removing geographical barriers to participation, provide novel ways to motivate healthy behaviors, facilitate high-frequency assessments, and enable more objective data collection. Although the studies have great potential, they also have notable limitations. These include selection bias, identity uncertainty, design limitations, retention, and privacy. As smartphone technology becomes increasingly available, researchers must recognize these factors to ensure that medical research is conducted appropriately. Despite these limitations, the future of smartphones in health research is bright. Their convenience grants unprecedented geographic freedom to researchers and participants alike and transforms the way clinical research can be conducted.
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            Assessment of bruxism in the clinic.

            Bruxism is a much-discussed clinical issue in dentistry. Although bruxism is not a life-threatening disorder, it can influence the quality of human life, especially through dental problems, such as tooth wear, frequent fractures of dental restorations and pain in the oro-facial region. Therefore, various clinical methods have been devised to assess bruxism over the last 70 years. This paper reviews the assessment of bruxism, provides information on various assessment methods which are available in clinical situations and discusses their effectiveness and usefulness. Currently, there is no definitive method for assessing bruxism clinically that has reasonable diagnostic and technical validity, affects therapeutic decisions and is cost effective. One future direction is to refine questionnaire items and clinical examination because they are the easiest to apply in everyday practice. Another possible direction is to establish a method that can measure actual bruxism activity directly using a device that can be applied to patients routinely. More clinical studies should examine the clinical impact of bruxism on oral structures, treatment success and the factors influencing the decision-making process in dental treatment.
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              Compliance with continuous positive airway pressure therapy: assessing and improving treatment outcomes.

              Although nasal continuous positive airway pressure (CPAP) is generally effective in correcting sleep-related respiratory disturbance and associated daytime sequelae in obstructive sleep apnea syndrome (OSAS), resistance to and intolerance of CPAP poses a serious limitation to its use. Failure to comply with treatment has been reported to be as high as 25 to 50%, with patients typically abandoning therapy during the first 2 to 4 weeks of treatment. Reasons for discontinuing CPAP therapy have been primarily related to issues of mask discomfort, nasal dryness and congestion, and difficulty adapting to the pressure. Although there has been great variability in the reported rates of CPAP compliance, there have been few systematic studies to evaluate barriers to CPAP compliance or ways to improve compliance. Early identification of CPAP-related tolerance problems or barriers, psychological factors, and the predictive value of pretreatment background variables ( ie, age and gender) may enhance compliance with therapy. An important goal for OSAS management is the development of intervention strategies and educational approaches that minimize side effects and maximize patient compliance. A new classification is presented, along with suggestions and ideas for intervention.
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                Author and article information

                Contributors
                m.thymi@acta.nl
                Journal
                J Oral Rehabil
                J Oral Rehabil
                10.1111/(ISSN)1365-2842
                JOOR
                Journal of Oral Rehabilitation
                John Wiley and Sons Inc. (Hoboken )
                0305-182X
                1365-2842
                06 March 2020
                May 2020
                : 47
                : 5 ( doiID: 10.1111/joor.2020.47.issue-5 )
                : 557-566
                Affiliations
                [ 1 ] Department of Orofacial Pain & Dysfunction Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam Amsterdam The Netherlands
                Author notes
                [*] [* ] Correspondence

                Magdalini Thymi, Department of Orofacial Pain & Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Gustav Mahlerlaan 3004, 1081LA, Amsterdam, The Netherlands.

                Email: m.thymi@ 123456acta.nl

                Author information
                https://orcid.org/0000-0002-8544-6495
                https://orcid.org/0000-0002-4448-6781
                https://orcid.org/0000-0001-9877-7640
                Article
                JOOR12945
                10.1111/joor.12945
                7317933
                32056251
                21a1184e-9a8f-49dd-b8ad-bdb0295379fe
                © 2020 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 August 2019
                : 03 February 2020
                : 09 February 2020
                Page count
                Figures: 2, Tables: 3, Pages: 10, Words: 7628
                Funding
                Funded by: Sunstar Suisse SA
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                May 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.4 mode:remove_FC converted:26.06.2020

                Dentistry
                ambulatory,electromyography,experience,mixed methods,sleep bruxism,smartphone
                Dentistry
                ambulatory, electromyography, experience, mixed methods, sleep bruxism, smartphone

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