Filling a Gap in the Bruxism Puzzle

April 3, 2001 Sleep Bruxism Getting a good night's sleep is a great way to start the day. However, many people are plagued by sleep disorders that prevent them from getting the amount of sleep they need to feel rested. One common sleep disorder is sleep bruxism. Sleep bruxism, also known as tooth grinding, is the third most common sleep disorder. (Sleep talking and snoring are the two most common.) Most tooth grinding occurs during stage 2 sleep, but it can also occur during rapid eye movement (REM) sleep. Sleep bruxism is sometimes so severe that the grinding noise is loud enough to be heard by other people in the same room. The grinding may also wear down teeth so severely that dental work is required. A study published in the journal Chest (January, 2001) detailed some of the risk factors associated with sleep bruxism.

Sleep researchers from Stanford University conducted phone interviews with 13,057 people in the United Kingdom, Germany and Italy. A formal diagnosis of bruxism requires that tooth grinding be accompanied by at least one other symptom such as abnormal tooth wear, muscular discomfort or tooth grinding sounds. Following the interviews, researchers analyzed the data and determined how many people had sleep bruxism and whether the diagnosis of bruxism was associated with 1) gender or age, 2) other sleep disorders, 3) the use of drugs or medications and 4) mental disorders.

Sorting the Data
In the survey population:
8.2% said that tooth grinding occurred at least once a week.	23% said that they need dental work because of their tooth grinding.
8.1% said that their jaw muscles hurt when they woke up.	23.3% said that their bed partner could hear their tooth grinding.
Men (4.1%) and women (4.6%) had about the same rate of bruxism.	The highest rate of sleep bruxism was found in people between the ages of 19 and 44 years and the lowest rate was found in people 65 years and older.
Snoring, breathing pauses during sleep, sleep talking, and sleep paralysis were more common in those people with sleep bruxism and tooth grinding than in other people in the sample.	A higher incidence of sleep bruxism was seen in people who drank more alcohol at bedtime, drank more than six cups of coffee a day, smoked cigarettes or had mental disorders (e.g., anxiety disorders, depression).
People with sleep bruxism woke up more often during the night, were more tired during the day and had more morning headaches compared with people without tooth grinding.

Cause and Effect? The data show that sleep bruxism is associated with breathing problems during sleep, snoring, awakenings, daytime sleepiness and several other sleep disturbances. The use of alcohol, tobacco and coffee also are associated with sleep bruxism. The data do not suggest that sleep bruxism is caused by these factors, but do say they are related. It is possible that a common anatomical or physiological problem is responsible for these associated disorders, but the underlying cause of sleep bruxism is unknown. Certainly more research is necessary to get to the root of the problem.

Bruxism: Up Close (Too Close) and Personal by Ellen Kuwana Neuroscience for Kids Staff Writer Snuggled in bed, I am asleep next to my husband. In the middle of the night, I'm jolted awake by a sound so annoying it's difficult to describe. It's like the awful high-pitched whine of metal grinding on metal, like the sound a car brake pad makes when it needs replacing. It's like fingernails scraping down the chalkboard. It's like a cricket on steroids chirping into a megaphone. And it's in my bed...it's my husband! My husband grinds his teeth in his sleep. Fortunately, it doesn't happen every night, or he'd find himself replaced by our faithful Border Collie. It's difficult to find a pattern to his teeth grinding, but it often happens when he's stressed. Most often, he grinds his teeth after he's been asleep for a short time, jut when I'm in a deep sleep. Therefore, the noise that he makes must be quite loud to wake me. Once awakened, I'm faced with a dilemma: do I wake him to get him to stop or do I let him sleep and hope that he stops?. There's no predicting when he'll stop grinding his teeth, so I usually wake him up so that he can put on his mouth guard. The guard is made of hard plastic that was molded by a dentist to fit his bottom teeth. This prevents his upper and lower teeth from contacting each other, thus preventing--yea!--any noise. All this tooth grinding has changed the shape of his teeth; the wear and tear has made his teeth flat, even in the front of his mouth. My husband was curious about what sound he makes when he grinds his teeth. It's interesting that he can't reproduce the sound when he's awake! He tried grinding his teeth while awake, but it does not make any sound at all! Just as well--it's bad enough that I have to hear that awful noise at night.

References and further information about sleep disorders: Ohayon, M.M., Kasey, K.L. and Guilleminault, C., Risk factors for sleep bruxism in the general population. Chest, 119:53-61, 2001. Tooth grinding from the Astoria Dental Group SleepQuest TalkAboutSleep.com