Teeth Grinding and Sleep Apnoea

I thought this might be worth sharing – we commonly associate obstructive sleep apnoea with snoring and gasping for breath. This article talks about teeth grinding in relation to this condition and should be considered when assessing sleep disorders.

Teeth grinding on its own can lead to other health problems such as headache, jaw or ear pain, aching teeth and jaws, and strain on the joints and soft tissue of the jaw. Often people are not even aware they are grinding their teeth (some partners however are).

Recent research presented at CHEST 2009 – the 75^th annual international scientific meeting of the American College of Chest Physicians highlighted a link between night time teeth grinding (bruxism) and those that suffer from Obstructive Sleep Apnoea (OSA).

Researchers focussed on the potential influence of factors such as gender, ethnicity, gastroesophageal reflux and bruxism in relation to OSA. The small retrospective study looked at 150 men and 150 women with OSA, and was made up of 50 Caucasians, 50 African-Americans, and 50 Hispanics in each group.

Overall, 25.6% of patients were teeth grinders (almost one in four), and 35% complained of gastroesophageal symptoms and heartburn at night. Results showed a higher incidence of bruxism in men than women (43% VS 31%) and when comparing ethnic groups, Caucasians demonstrated the highest rate of bruxism (35%). The highest rate of gastroeosophageal reflux was seen in the African-American study group – 40% VS 34% in Caucasians and 31% in the Hispanic population groups.

Other factors cited which are believed to link OSA and bruxism are anxiety and caffeine. We already know that OSA (untreated or poorly controlled) can lead to altered mood including depression and anxiety. Sleep deprivation can in turn lead to a high intake of caffeine which can in turn be associated with a high risk of teeth grinding.

It is the end of an apnoeic event (usually after an arousal) that sleep bruxism is often seen. I t has been suggested that as men usually have more severe OSA, and therefore more associated arousals per night that this may explain a higher percentage of men in this group suffering from teeth grinding.

Finally, some studies are suggestive of treatments such as Continuous Positive Pressure Therapy (CPAP) for OSA in helping treat and potentially eliminate the secondary health problem of nocturnal bruxism.

We regularly receive referrals at Regional Respiratory Medicine from Oral Medicine Specialists and General Dentists who recognize how one or more symptoms might be associated with other conditions such as sleep apnoea.

Lisa