Sleep apnea and sleep bruxism are two health conditions that typically occur during sleep. Although they represent different nocturnal activities, scientific research indicates they may be connected. In fact, a 2009 report from the American College of Chest Physicians (ACCP) reveals a high prevalence of sleep bruxism in people with obstructive sleep apnea (OSA).
Sleep bruxism is characterized by nighttime teeth grinding, gnashing or clenching. People with this condition unconsciously grind their teeth during sleep. Many are unaware of their problem.
Mild bruxism rarely requires medical treatment. On the other hand, frequent or severe cases may cause headache, earache, face or jaw pain, tooth damage and other problems.
Stress, anxiety, anger and frustration are contributors to nocturnal teeth grinding. Additional factors include smoking, taking illegal drugs and drinking alcohol or caffeinated beverages.
Sleep apnea is a sleep disorder with potentially dangerous complications. It involves repeated stops and starts in breathing. People with this condition usually snore loudly during sleep and feel tired when they awake.
There are two main types of sleep apnea: obstructive sleep apnea and central sleep apnea. OSA, the more common form, occurs when throat muscles relax during sleep. The other form involves problems with the brain signals that control breathing. Complex sleep apnea, a less common form, combines the two.
Sleep apnea results from a narrow or blocked airway. The inability to breathe arouses the sleeper and reopens the airway. Most people do not remember awakening, although the process may repeat several times throughout the night. Obesity, high blood pressure, advanced age, medications, alcohol consumption and smoking may increase the risk of OSA.
The Connection between Bruxism and Sleep Apnea
The relationship between sleep bruxism and sleep apnea usually stems from an arousal response. When an apnea event ends, various oral phenomena may occur: snoring, mumbling, gasping, grunting and teeth grinding.
Stress, anxiety and caffeine ingestion are additional explanations. Studies link high anxiety levels to bruxism, and sleep apnea itself may cause anxiety. Additionally, the daytime sleepiness caused by apnea may lead to high levels of caffeine consumption which, in turn, is linked to a high risk of bruxism.
When bruxism is associated with OSA, certain therapies may treat both problems. Continuous positive airway pressure (CPAP) keeps a sleeper’s airway open to allow for normal breathing. It has also been shown to decrease sleep bruxism. CPAP machines can be combined together in a custom configuration with a patient’s night guard to protect against both problems.