Nocturnal Teeth Grinding Linked With Incidence of Other Sleep-Related Disorders

People experiencing teeth grinding or clenching during sleep, called sleep bruxism, were found to be more likely than the general population to report incidence of other sleep disorders, such as obstructive sleep apnea and restless leg syndrome.

Sleep bruxism (SB)—a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth during sleep—may be a risk factor for the development of other sleep-related disorders, according to study findings published in Sleep Medicine.

With a prevalence of more than 10% in adult populations, SB has been associated with several adverse symptoms, including headache upon awakening, temporomandibular pain complaints, and severe mechanical tooth wear.

Moreover, researchers note that prior research has suggested that the genesis of SB events may be preceded by a cascade of events in relation to sleep arousals, which have been linked with other sleep-related disorders, such as obstructive sleep apnea (OSA) and epilepsy.

“However, systematic reviews on SB as a comorbid condition of other sleep-related disorders are lacking so far. Such reviews would contribute to the insight of sleep clinicians into the occurrence of SB in patients suffering from other sleep-related disorders, as well as into the underlying mechanisms of such comorbid associations,” they said.

Seeking to determine the prevalence of SB in adult patients with other sleep-related disorders, as well as identify potential underlying mechanisms of these associations, they conducted a systematic review of relevant studies published in PubMed, Embase, Cochrane Library, and Web of Science databases until May 15, 2020.

Using the Risk of Bias Assessment tool for quality assessment of the nonrandomized studies, 1539 studies were collected, in which 37 qualified for the full-text reading phase and the subsequent systematic review.

In the review, prevalence of SB was found to be significantly higher in adult patients with OSA, restless leg syndrome, periodic limb movement during sleep, sleep-related gastroesophageal reflux disease, REM behavior disorder (RBD), and sleep-related epilepsy, compared with the general population.

Further associations with Parkinson disease (PD) were identified in those with SB, but the specific mechanisms behind this and other positive associations could not be identified.

“Even though the specific mechanisms behind the associations between SB and other sleep-related disorders have not been identified yet, considering all the available evidence, sleep arousals could be a common factor with which all the identified disorders are associated, except RBD and PD,” the authors wrote.

The researchers concluded that the associations between SB and these sleep-related disorders call for more SB screening in patients with these conditions. Furthermore, they recommended for medical specialists to raise awareness of SB as a potential indicator for associated sleep-related disorders and to advocate the closer collaboration between medical specialists and dental practitioners.

Reference

Kuang B, Li D, Lobbezoo F, et al. Associations between sleep bruxism and other sleep-related disorders in adults: a systematic review. Sleep Med. Published online November 19, 2021. doi:10.1016/j.sleep.2021.11.008