Are You Grinding Your Way to Sleep Apnea?

From the WebMD Archives

Jan. 24, 2001 -- Maybe you encountered the distracting nighttime noisemaker while at summer camp. Or perhaps the culprit was your own sibling, parent, or spouse? Hey, maybe it's even you. That's right, we're talking about teeth grinders. You know, those people who grind away incessantly in their sleep while those around them cringe under the sheets. Sure, we may have made fun of them as kids, and some of us have perhaps lost sleep because of them, but you probably never realized that their sleeping behavior is more than annoying -- it actually may be harmful.

A new study of more than 13,000 people in the U.K., Germany, and Italy finds that people who grind their teeth while sleeping have higher rates of breathing problems and obstructive sleep apnea, a condition in which breathing pauses or stops periodically during sleep.

Teeth grinding is a common problem, yet many sufferers never talk about it with their doctors, and many doctors never think to ask. But experts say the consequences of teeth grinding can be serious.

Over the years, teeth grinding can wear down and loosen teeth, cause jaw and facial muscle pain, and be a source of headaches. Those are reasons alone to diagnose teeth grinding as soon as possible, but the association with sleep apnea reported in the January issue of the medical journal Chest adds urgency to the problem, says the study's author, Maurice M. Ohayon, MD.

Ohayon says both patients and doctors often think of teeth grinding as, "a little problem without any importance," and some doctors may dismiss it or discourage patients from talking about it. But Ohayon, of Stanford University School of Medicine, says he hopes his study will encourage doctors to ask questions and patients to volunteer information about their sleep habits.

He says it's better to risk a bored look from your doctor than risk losing your teeth or letting a sleep disorder go unrecognized. Although not addressed in this study, Ohayon says his group believes treating teeth grinding may prevent or delay sleep apnea and other serious sleep disorders in which breathing is affected.

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For the study, researchers interviewed randomly selected participants by phone. The people were asked about their sleeping habits, sleeping problems, mental health problems, and general questions about their lifestyle.

The researchers found that grinding or clenching teeth during sleep on a weekly basis affected about one in 10 people in the study. More than half of those with tooth grinding said they had some problem related to the condition, and about one-quarter of them said their teeth grinding was loud enough for their bed partner to hear. One-quarter also said they needed some dental work as a result of their nocturnal activity.

Although teeth grinding is considered primarily a dental problem, it also is classified as a sleep disorder, says Alon Y. Avidan, MD, MPH. He says type A personalities and perfectionists make up a significant percentage of teeth grinders. And most teeth grinders are born, not made, meaning they start out grinding in childhood and continue the behavior as they age.

Avidan, who is clinical assistant professor of neurology at the Michael S. Aldrich Sleep Disorders Laboratory at the University of Michigan in Ann Arbor, agrees that talking to your doctor is essential. Teeth grinding can be diagnosed by your doctor asking you specific questions or in a sleep laboratory, if needed.

Once diagnosed, teeth grinding can be treated in a number of ways.

These can include reducing your intake of alcohol, cigarettes, and caffeine, all of which were associated with higher likelihood of teeth grinding in the study. Reducing anxiety and stress also can be helpful since it appears that those conditions play a role in increasing the frequency of teeth grinding. Finally, many patients are given dental guards to wear while they sleep to hold their jaw muscles still and prevent the rhythmic activity that causes the teeth to grind together.

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