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Sleep Bruxism: Mapping Potential Direct and Indirect Risk Pathways in EPISONO Adult Population-Based Study.

Eduardo Machado¹, Jessica Klöckner Knorst², Milton Maluly Filho¹

¹Department of Psychobiology, Universidade Federal de Sao Paulo, São Paulo, Brazil.

Journal of Oral Rehabilitation

|December 8, 2025

Summary

This summary is machine-generated.

Sleep bruxism (SB) is influenced by various factors. Insomnia and younger age directly predict SB, while psychological issues indirectly impact it through insomnia, affecting overall sleep health.

Keywords:

adults comorbidities observational study pathway analysis sleep sleep bruxism sleep disorders

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Area of Science:

Sleep Medicine
Epidemiology
Psychology

Background:

Sleep bruxism (SB) is a common sleep-related movement disorder.
Understanding the multifactorial influences on SB is crucial for effective management.

Purpose of the Study:

To investigate the direct and indirect pathways linking sociodemographic, psychological, behavioral, and clinical factors to sleep bruxism (SB).

Main Methods:

Cross-sectional study of 686 adults from the Sao Paulo Epidemiological Sleep Study (EPISONO).
Sleep bruxism assessed via self-report, polysomnography (PSG), and combined methods.
Structural Equation Modelling used to analyze risk factor pathways.

Main Results:

Prevalence: 17.1% self-reported SB, 30.5% PSG-based SB, 7.4% combined.
Direct associations: SB linked to insomnia and younger age. Higher socioeconomic status correlated with self-reported SB.
PSG-based SB associated with obstructive sleep apnea and smoking. Anxiety and depression indirectly impacted SB via insomnia.

Conclusions:

Distinct pathways influence sleep bruxism (SB), with insomnia and younger age being consistent predictors.
Psychological factors, such as anxiety and depression, indirectly affect SB through increased insomnia.
Demographic, behavioral, and clinical factors show direct associations with SB, varying by assessment method.