Effect of trazodone on sleep bruxism in children and adolescents 6-18 years of age, a pilot study

BACKGROUND: Sleep bruxism is a common sleep disorder with unclear etiology and no definitive treatment. Recent suggested medications are not often practically used due to their numerous limitations. Based on the fact that sleep bruxism occurs most often in the second stage of non-REM sleep, this study aimed to assess the effect of trazodone on sleep bruxism. METHODS: This pilot study was conducted as a before-after design on 28 children and adolescents with 6-18 years of age suffering from sleep bruxism referring by children and adolescents mental health clinic, children dental specialists and pediatricians. The treatment started with 0.5mg/kg/day. In non-responders, it was weekly added by 0.5 mg/kg/day (with optimum of 2 mg/kg/day). Frequency of bruxism and related morning face/jaw pain were assessed daily from two weeks before (baseline) to four weeks after starting the intervention by the parents/roommate. RESULTS: Findings showed a significant reduction in the frequency of both bruxism and related morning pain from baseline to the 2 and the 4 weeks of the intervention (P<0.001). Minor side effects such as drowsiness, nausea and dry mouth were seen among approximately one-third of the patients. These side effects were self-limited and tolerable. CONCLUSIONS: Trazodone could be effective in reducing the frequency of sleep bruxism and its related morning face/jaw pain. Well-designed placebo-controlled trials are needed to confirm the results.