Why Do I Grind My Teeth When I Sleep?

Everyone grinds their teeth or snores occasionally. But when tooth grinding becomes constant, it indicates deeper problems. Just like snoring, tooth grinding is a symptom of something else. It’s caused by a variety of factors and can be treated in several different ways.

Anxiety

Anxiety can lead to many physical repercussions. Anxiety and stress can interfere with sleep in several ways. Studies demonstrate that people undergoing stress at work are more likely to grind their teeth. Stress connects with our natural “fight-or-flight” response, and a nerve links the jaw to the part of the brain which governs that response.

If we’re constantly in “fight” mode, under chronic stress, this nervous connection can lead to jaw-clenching and teeth-grinding.

Normal Sleep

Some teeth grinding, or “bruxism,” during sleep seems to be connected to changes in sleep levels. Bruxism is associated with sleep stages 1 and 2—86% of episodes occur in these levels, generally involving lighter sleep. Only 7% of episodes take place during REM sleep, but those are frequently associated with facial and dental pain.

Sleep Disorders

Teeth grinding may also relate to sleep disorders. Some research indicates that bruxism during sleep is strongly connected with sleep apnea. Tooth grinding is the body’s way to reopen a blocked airway—even fetuses in the womb do it. While long-term tooth-grinding can lead to tooth problems, it’s a more immediate symptom of a deeper problem.

Fixing Awake Bruxism

If you clench or grind your teeth while you’re awake, it’s most likely related to work or life-related stresses. Behavioral modification is frequently indicated. Habit reversal therapy, habit awareness, and relaxation techniques should help alleviate awake bruxism.

Fixing Sleeping Bruxism

A variety of techniques has been used in the treatment of sleeping bruxism. Some are more effective than others.

• Sleep hygiene measures—sleep hygiene includes reducing or eliminating the consumption of alcohol, tobacco, and caffeine at night. Also, sleep hygiene includes a quiet and dark room, as well as limiting physical and mental activities before bed. Sleep hygiene measures may be in the “chicken soup” category—they can’t hurt, but by themselves, they don’t seem to have much effect.
• Splints—a variety of devices are available for patients to wear during sleep. They cover the full dental arch on either jaw. These splints have the highest effect during the first two weeks of use. They may also negatively affect patients with obstructive sleep apnea.

Given the limited effect many treatments have for sleeping bruxism, the best treatment for bruxism not connected to sleep apnea may be behavior modification coupled with tooth protection.

Teeth-grinding and Sleep Apnea

Patients with obstructive sleep apnea (OSA) may discover their apnea when their partner comments on snoring or tooth grinding. Roughly one-quarter of all patients with OSA demonstrate bruxism. There are some indications that men are more likely to grind their teeth than women. Some ethnic connections to bruxism also seem present.

Sleep apnea is caused when the muscles in the back of your throat relax during sleep. These muscles all support the tongue, soft palate, uvula, tonsils, and side walls of the throat. During this relaxation, the airway can narrow, or even close. A closed or narrowed airway prevents adequate breathing, and the oxygen level in your blood lowers.

Teeth grinding simply allows the airway to reopen. The unconscious brain reacts to the low oxygen levels in the blood. Snoring may also occur. Treatment for sleep apnea may reduce or eliminate sleeping bruxism.

Treatment for Sleep Apnea

Reducing the risk factors for sleep apnea can help reduce its incidence. Risk factors for OSA include

• Excess weight—fatty deposits around the upper airway can add to the obstruction, but not all sufferers are overweight
• Use of alcohol, sedatives, or tranquilizers—since these substances lead to muscle relaxation, they can contribute.
• Smoking—smoking can increase fluid retention and inflammation in the upper airway.

A patient can lessen symptoms by sleeping on their side.

For mild cases of OSA, doctors may recommend lifestyle changes. If allergies are connected to the OSA, treatment for the allergy may be indicated.

Oral appliances are frequently used by OSA patients. These devices help keep the throat open, either by bringing the jaw forward or by supporting the tongue. They do take some getting used to while sleeping but do help.

Continuous positive airway pressure (CPAP) devices provide effective relief. The device delivers air pressure through the nose, keeping the airway open. They do work but may be awkward or uncomfortable. They sometimes do not help eliminate snoring.

Conclusion

Tooth grinding is a symptom. It may indicate you are under stress. It may also indicate a serious sleeping disorder. If you think that sleep apnea may be your problem, you should see your physician.