Are Bruxism and Sleep Apnea Related?

Key Takeaways

• Many people with obstructive sleep apnea grind their teeth at night. While the precise link is unclear, bruxism may result from a micro-arousal when the airway is obstructed. 
• You don’t necessarily have OSA if you grind your teeth during sleep.
• If you have breathing issues at night, snore regularly, and experience daytime sleepiness, you may wish to consult a doctor about sleep apnea.
• Treatments for sleep-related bruxism include treating sleep apnea, wearing oral devices like nightguards, and making lifestyle changes.

Are Sleep Apnea and Teeth Grinding Related?

Research shows that obstructive sleep apnea (OSA) and teeth grinding (bruxism) may be related.¹

OSA is the most common sleep-related breathing disorder, with one study estimating that one billion people are affected by it worldwide.² People with OSA experience breathing interruptions while sleeping due to airway obstructions. 

Sleep-related bruxism is the habit of grinding your teeth while sleeping. Up to 31% of adults grind their teeth while asleep, but it’s especially common in people with OSA.³

How are Bruxism and Sleep Apnea Connected?

Studies have found that around one-third of people with OSA grind their teeth during sleep.⁴ However, the link between obstructive sleep apnea and teeth grinding remains unclear. 

One theory suggests an airway obstruction can cause an arousal response such as tooth grinding.⁵ 

An airway obstruction occurs when someone’s tongue or other soft tissues block their throat. Their body responds with a micro-arousal to restart breathing, triggering the nervous system and stimulating muscle activity.

People with sleep apnea experience these repetitive micro-arousals without fully waking throughout the night. Bruxism may be part of their body’s attempt to breathe again after airway obstruction.

What is Sleep Bruxism?

Sleep bruxism refers to the grinding of the teeth at night. It’s a common habit that doesn’t always indicate the presence of sleep apnea, though sleep bruxism is more common in people with sleep apnea. 

Signs of sleep bruxism include:

• Headaches upon waking
• Jaw or neck pain
• Tooth damage or changes in bite
• Unexplained loose teeth
• Sensitivity in the teeth, especially to extreme temperature
• Trauma to the soft tissues of the mouth, such as the insides of the cheeks and the sides of the tongue 

While the presence of sleep bruxism doesn’t always indicate OSA, consult a doctor if you notice significant bruxism-related symptoms. 

Who is at Risk of Developing Bruxism and Sleep Apnea?

It’s unclear who’s more likely to develop sleep apnea and bruxism simultaneously. However, they share many common risk factors, including:

• High levels of stress and anxiety, such as at work or school
• Tobacco or alcohol use
• Excessive caffeine consumption
• Neurological disorders like cerebral palsy or Down syndrome
• Certain medications and drugs, especially amphetamines and antipsychotics
• Gastroesophageal reflux disease (GERD)
• Family history of OSA or bruxism

Treatments for Sleep-Related Teeth Grinding

There are many different treatments for sleep bruxism, including:

Positive Airway Pressure (PAP) Therapy

If you have obstructive sleep apnea, treating it can relieve and prevent nighttime teeth grinding and clenching. 

The most common and effective treatment for OSA is a continuous positive airway pressure (CPAP) machine. A CPAP machine sends air into your nose or mouth via a tube and a mask. You’ll need to wear this mask all night to prevent airway obstruction. 

PAP therapy is highly effective, but people often stop using their machines because it’s uncomfortable and bulky.⁶

Oral Appliances

Wearing a mouthguard can prevent teeth damage from grinding or clenching. The most common oral appliances for bruxism are:

• Night guards — Also known as an oral splint, a night guard protects your teeth while sleeping. You can get one custom fitted by your dentist or buy one over the counter.
• Mandibular advancement device (MAD) — A MAD is a custom-made oral device that moves your jaw forward to open your airway. It’s the most common oral appliance recommended for OSA.

Better Sleep Habits

Making a few tweaks to your routine can drastically improve your sleep hygiene. Some tips for practicing better sleep habits include:

• Don’t drink alcohol or caffeine at night
• Avoid smoking and tobacco use
• Exercise regularly
• Practice relaxation techniques
• Stop using screens an hour before bedtime

If you’re taking medication that interferes with sleep, consult your doctor about possible alternatives. Improving nasal allergies can also help with sleep.

What About Snoring, Bruxism, and Sleep Apnea?

Snoring isn’t always a sign of an underlying issue. It can occasionally happen due to a sinus infection, alcohol use, etc. 

However, chronic snoring is a common symptom of OSA. In addition, studies have demonstrated that snoring and teeth grinding often go together.⁷ 

You may want to consult with a doctor if you or your partner notice those two symptoms together regularly, along with symptoms like:

• Pauses in breathing during sleep
• Daytime sleepiness
• Trouble concentrating
• Morning headaches or sore throat
• Restless sleep

These signs may point to obstructive sleep apnea, which requires treatment.