Obstructive Sleep Apnea and Bruxism

New research presented at CHEST 2009 found that nearly 1 in 4 patients with obstructive sleep apnea (mostly Caucasian men) suffers from nighttime teeth grinding.

Eight percent of the general US population suffers from bruxism.

“The relationship between obstructive sleep apnea and sleep bruxism is usually related to an arousal response. The ending of an apneic event may be accompanied by a number of mouth phenomena, such as snoring, gasps, mumbles, and teeth grinding,” said Shyam Subramanian, MD, FCCP, Baylor College of Medicine, Houston, TX. “Men typically have more severe sleep apnea, and perhaps may have more arousal responses, which may explain the higher prevalence of teeth grinding in men. Besides, men characteristically tend to report more symptoms of sleep apnea than women, such as snoring, loud grunting, and witnessed apneas.”

Anxiety and caffeine use also help explain the relationship between sleep apnea and teeth grinding.

Through a retrospective chart review, Dr. Subramanian assessed the prevalence of bruxism and gastroesophageal reflux (GERD) in 150 men and women. Each group consisted of 50 Caucasians, 50 African-Americans, and 50 Hispanics. Results showed that 25.6 percent of patients suffered from teeth grinding, while 35 percent of all patients with OSA complained of nocturnal heartburn and GERD symptoms.

The researchers also examined the influence of gender and ethnicity on OSA, GERD, and bruxism. They found that bruxism was higher in men than in women. Caucasians had the highest rate of bruxism compared to other ethnic groups. African-Americans have the highest prevalence of GERD.

Untreated bruxism can lead to excessive tooth wear and decay, periodontal tissue damage, jaw pain, and temporomandibular joint or TMJ pain, headaches, and sleep disturbances for patients and their bed partners.

“Bruxism can be both a daytime syndrome as well as a nighttime syndrome, but it is bruxism during sleep, including short naps, that causes the majority of health issues.”

Adapted from materials provided by American College of Chest Physicians.

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