Submitted by Koala Center for Sleep Disorders
That embarrassing snoring habit your spouse complains about may have something in common with your worn down teeth the dentist is always pointing out to you at your appointments. Your dentist may have been telling you for years that you grind your teeth. Maybe you use a nightguard to protect your pearly whites. In most people, teeth grinding, or bruxism, is mild enough to not be a health problem. But research indicates that teeth-grinding may be a sign of something more dangerous to your health.
Sleep should be a calm, peaceful endeavor. For people with sleep bruxism — tooth-grinding or clenching at night — sleep can become a noisy, gnashing, and not-so-restful situation. You may notice yourself gritting your teeth at tense moments. Sleep bruxism, however, happens when you’re sound asleep, and so it can often go undetected. Those most likely to notice it are dentists spotting worn-down or fractured teeth or bed partners kept awake through the night by the grating, rasping sounds of teeth sliding across teeth.
What causes people to grind their teeth? Many times a misaligned bite is to blame. Stress and anxiety are thought to trigger or make the nocturnal grinding worse as well as those who drink lots of alcohol or caffeine or smoke. Most people are unaware of their teeth grinding just as they are unaware of their loud snoring or pauses in breathing, which can be a sign of a much more serious sleep disorder, such as sleep apnea.
Research presented in 2009 by the American College of Chest Physicians (ACCP) showed that one in four patients suffering from obstructive sleep apnea (OSA) also suffered from nocturnal bruxism, commonly known as nighttime teeth grinding. OSA occurs when the tissue in the back of the throat collapses and blocks the airway, reducing the amount of oxygen delivered to all of your organs, including your heart and brain. Warning signs of sleep apnea are waking up unrefreshed, morning headaches, daytime sleepiness, depression or mood changes, impaired concentration, loud snoring, and waking up gasping for air.
The comorbidities associated with the disease are very serious, including increased risk of high blood pressure, stroke, heart attack, diabetes, and depression. When you have sleep apnea, you can cease breathing for ten seconds or more, and this happens repeatedly during the sleep cycle. When you stop breathing, your mind wakes your body enough to restart the breathing process. The cycle repeats hundreds of times a night, and these awakenings or arousals are associated with increases in sleep bruxism. While daytime teeth-grinding and clenching is common, the destruction associated with bruxism is usually due to grinding in your sleep, when you can’t control it.
While bruxism doesn’t guarantee you have obstructive sleep apnea, it is important to watch for signs of the condition. Occasionally, bruxism causes no symptoms at all, but left unchecked, sleep bruxism can lead to complications, including sensitive, worn, or damaged teeth; tension headaches; and jaw and facial pain, or it can result in a temporomandibular joint disorder (TMD). It may even trigger earaches due to referred pain or because of the proximity of the ear canal to the muscles of the jaw as well as stiffness and tenderness in the neck and shoulders.
Teeth grinding is actually a very common habit among children, particularly those under age 11. It’s so common, in fact, that it is often considered normal behavior, which is often not the case. Bruxism signs to watch out for in kids include the tell-tale grinding noise during sleep, thumb-sucking, nail-biting, or gnawing on the inside of their cheek or on objects like pencils. A link exists between teeth grinding and enlarged tonsils as well as sleep apnea in children, which in turn is strongly correlated to upper airway obstruction. Asthma and respiratory airway infections may also be factors in bruxism. Children who grind their teeth and who do not sleep well may be suffering from airway obstruction at night. They may wet their bed, perform poorly in school, have behavioral problems, or have symptoms of ADHD. Hyperactivity is also associated with bruxism as are the amphetamines used for managing attention deficit hyperactivity disorder (ADHD). For these reasons, bruxism should never be considered a normal behavior in children.
This seemingly harmless nuisance may have grave health consequences if left untreated, especially if you have untreated obstructive sleep apnea, which can be life-threatening. Addressing these issues can drastically improve your quality of life. If you or a loved one snores or grinds their teeth, make an appointment with your health care provider. Have your dentist check for signs of teeth grinding. If you have symptoms of sleep apnea, be sure to consult your physician or a sleep specialist.
For more information on Oral Appliance Therapy for Snoring, Sleep Apnea, and TMJ Disorder please contact Dr. Gray at Koala Center for Sleep Disorders in Bloomington at 309-319-6568 or visit bloomingtonsleep.com to schedule an appointment.