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Sleep bruxism and pediatric obstructive sleep apnea: exploring their chronological overlap and clinical significance

Elfatih Eisa1, Fernanda Yanez-Regonesi2, Jeffrey P Okeson2

  • 1ClearChoice Dental Implant Center, Edwardsville, IL, USA.

Sleep & Breathing = Schlaf & Atmung
|November 11, 2025
PubMed

Insights

In children with obstructive sleep apnea (OSA), sleep bruxism (SB) events often temporally associate with apnea-hypopnea (AH) events, suggesting a shared arousal mechanism. This link between SB and AH in pediatric OSA warrants further investigation.

Area of Science:

  • Pediatric Sleep Medicine
  • Sleep Disorders
  • Neurology

Background:

  • Obstructive sleep apnea (OSA) is common in children.
  • Sleep bruxism (SB), characterized by rhythmic masticatory muscle activity (RMMA), is a common condition.
  • The temporal relationship between SB and apnea-hypopnea (AH) events in pediatric OSA is not well understood.

Purpose of the Study:

  • To investigate the temporal relationship between RMMA and AH events in children and adolescents with OSA.
  • To determine if AH events precede or follow RMMA events.
  • To explore potential shared mechanisms between SB and OSA.

Main Methods:

  • Retrospective review of 72 pediatric polysomnography (PSG) records (ages 6-17) with OSA diagnosis.
  • Identification of RMMA episodes using submental EMG.
  • Classification of temporal associations (AH before SB or SB before AH) within a 2-minute window.

Main Results:

  • Sleep bruxism (SB) was present in 43.1% of participants.
  • 61% of RMMA episodes were temporally associated with AH events.
  • SB participants showed significantly more RMMA and related events, and altered sleep architecture.

Conclusions:

  • A temporal association exists between SB and AH events in pediatric OSA.
  • This suggests a potential shared arousal-related mechanism.
  • The association appears indirect, and causality is unconfirmed.
Abstract

Keywords:
AdolescentsChildrenMicroarousalObstructive sleep apneaPolysomnographyRhythmic masticatory muscle activitySleep architectureSleep bruxismTemporal association

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