Teeth Grinding Linked to Sleep Apnea

Bruxism Prevalent in Caucasians with Sleep Disorders

SAN DIEGO, Nov. 2 /PRNewswire-USNewswire/ -- There is a high prevalence of
nocturnal teeth grinding, or bruxism, in patients with obstructive sleep apnea
(OSA), particularly in Caucasians. New research presented at CHEST 2009, the
75th annual international scientific assembly of the American College of Chest
Physicians (ACCP), found that nearly 1 in 4 patients with OSA suffers from
nighttime teeth grinding; this seems to be especially more prevalent in men
and in Caucasians compared with other ethnic groups.

It is estimated that 8 percent of the general US population suffers from
bruxism, a condition frequently associated with a preexisting dental or jaw
disorders, as well as stress.

"The relationship between obstructive sleep apnea and sleep bruxism is usually
related to an arousal response. The ending of an apneic event may be
accompanied by a number of mouth phenomena, such as snoring, gasps, mumbles,
and teeth grinding," said Shyam Subramanian, MD, FCCP, Baylor College of
Medicine, Houston, TX. "Men typically have more severe sleep apnea, and
perhaps may have more arousal responses, which may explain the higher
prevalence of teeth grinding in men. Besides, men characteristically tend to
report more symptoms of sleep apnea than women, such as snoring, loud
grunting, and witnessed apneas."

Other factors that might help explain the relationship between sleep apnea and
teeth grinding include anxiety and caffeine use.

"High levels of anxiety can lead to bruxism, and untreated sleep apnea is
known to cause mood disturbances including depression and anxiety," said Dr.
Subramanian. "Daytime sleepiness from sleep apnea may cause a person to ingest
caffeine, and this has also been associated with a high risk of bruxism."

Through a retrospective chart review, Dr. Subramanian and his colleagues, from
the Baylor College of Medicine, Houston, TX, assessed the prevalence of
bruxism and gastroesophageal reflux (GERD) in 150 men and 150 women with OSA.
Each group consisted of 50 Caucasians, 50 African-Americans, and 50 Hispanics.
Results showed that 25.6 percent of patients suffered from teeth grinding,
while 35 percent of all patients with OSA complained of nocturnal heartburn
and GERD symptoms.

The researchers also examined the influence of gender and ethnicity on OSA,
GERD, and bruxism. They found that bruxism was higher in men than in women --
43 percent vs. 31 percent. Caucasians had the highest rate of bruxism compared
to other ethnic groups -- 35 percent vs. 19 percent in Hispanics.
African-Americans have the highest prevalence of GERD -- 40 percent vs. 31
percent in the Hispanic population and 34 percent in Caucasians. Overall, no
correlation was observed between the presence of self-reported GERD and
bruxism.

Untreated bruxism can lead to excessive tooth wear and decay, periodontal
tissue damage, jaw pain and temporomandibular joint or TMJ pain, headaches,
and sleep disturbances for patients and their bed partners.

"Bruxism can be both a daytime syndrome as well as a nighttime syndrome, but
it is bruxism during sleep, including short naps, that causes the majority of
health issues," said Dr. Subramanian. "Studies do suggest that when sleep
bruxism is related to OSA, certain therapies, including continuous positive
airway pressure, may eliminate bruxism during sleep."

"Sleep disorders such as sleep apnea can lead to many secondary health
conditions," said Kalpalatha Guntupalli, MD, FCCP, President of the American
College of Chest Physicians. "When treating sleep apnea, clinicians must also
recognize and address secondary health conditions, such as bruxism, in order
to fully manage a patient's sleep disorder."

CHEST 2009 is the 75th annual international scientific assembly of the
American College of Chest Physicians, held October 31-November 5 in San Diego,
CA. The ACCP represents 17,400 members who provide patient care in the areas
of pulmonary, critical care, and sleep medicine in the United States and
throughout the world. The ACCP's mission is to promote the prevention and
treatment of diseases of the chest through leadership, education, research,
and communication. For more information about the ACCP, please visit the ACCP
Web site at www.chestnet.org.

SOURCE American College of Chest Physicians

Jennifer Stawarz of the American College of Chest Physicians, +1-847-498-8306,
jstawarz@chestnet.org