Grinding, clenching, or gnashing your teeth while you sleep — a condition known as sleep bruxism — might do more than impact the long-term health of your teeth and jaw. It could also influence whether you’re getting a good night’s rest.

In fact, studies have found that some people who grind their teeth at night also have obstructive sleep apnea (OSA). And though scientists aren’t sure why the two conditions sometimes co-occur, recognizing there might be a correlation can empower you to get the right testing and treatment.

So, whether you have sleep bruxism, sleep apnea, or both, here’s what you need to know about the two conditions and how they might be related.

Potential Connections Between Sleep Apnea and Tooth Grinding

Some researchers have found that sleep apnea and bruxism sometimes occur together. One study found that sleep bruxism occurred in 49.7 percent of people with obstructive sleep apnea (OSA). This prevalence is far greater than the 8 percent to 13 percent of people in the general population who grind or clench their teeth while they sleep.

Researchers don’t know for sure why these two conditions can occur together, but there are several theories on why this might happen. One of the more popular theories is that sleep bruxism is a protective response that takes place when the airway becomes blocked during sleep apnea.

Why the Two May Occur Together

Researchers are still studying why sleep apnea and sleep bruxism sometimes occur together. Brief awakenings or changes in breathing may play a role, but the exact connection is not known.

But because this protective reaction doesn’t work in severe obstructive sleep apnea (OSA), other researchers question the validity of this theory. They note that the lighter sleep in severe OSA may reduce the body’s ability to use bruxism as a defense mechanism.

More research is needed to understand why the two conditions sometimes occur together.

Observations on Co-Occurring Sleep Apnea and Bruxism

Research is still ongoing to determine the nature of the relationship between sleep apnea and bruxism. So far, scientists have uncovered several interesting findings.

Researchers have noted that some people with more frequent episodes of teeth grinding during sleep tend to also have a greater number of breathing pauses or instances of shallow breathing in sleep apnea.

Those with moderate to severe OSA tend to have more severe tooth wear.

Additionally, a research review found that older adult men with obesity may be at increased risk for both sleep apnea–hypopnea syndrome and sleep bruxism. Mouth breathing, snoring, morning headaches, and sleeping on the back were also common features of the two conditions.

More research is needed to determine the exact extent of the connection between sleep apnea and sleep bruxism. Until then, it’s important to understand that the two sometimes occur together. So if you have one condition, be on the lookout for signs of the other.

Signs of Nighttime Tooth Grinding

If you’re grinding your teeth at night, you likely won’t know unless someone tells you. That’s why it’s so important to recognize the potential signs of sleep bruxism. That way, you can let your dentist or your healthcare provider know what you’re experiencing.

Here are some common symptoms:

• Headaches
• Earaches
• Sore jaw muscles
• Tinnitus (ringing in your ears)
• Pain when eating
• Difficulty opening your mouth
• Flattened or fractured teeth
• Worn tooth enamel
• Jaw, neck, or facial pain

Left untreated, bruxism can lead to complications. Some risks include tooth damage, jaw soreness, headaches, or facial pain. Bruxism and temporomandibular joint (TMJ) disorder can occur together, but grinding doesn’t always cause a TMJ disorder.

Signs of Sleep Apnea

Like bruxism, you may not know you have sleep apnea unless someone tells you that you snore, choke, stop breathing, or gasp for breath while you’re sleeping. That’s why it’s so important to be aware of other signs of sleep apnea.

Some things to watch for include:

• Repeatedly waking up in the middle of the night
• Tossing and turning or feeling restless
• Waking up short of breath or feeling like you’re choking
• Snoring
• Unusual breathing patterns
• Daytime fatigue or sleepiness
• Feeling tired after waking up
• Headaches in the morning
• Dry mouth in the morning
• Night sweats
• Mood changes or irritability
• Difficulty paying attention
• Sexual dysfunction

Left untreated, sleep apnea may lead to chronic health conditions and reduce your life expectancy. For instance, you could develop a number of heart-related conditions such as high blood pressure, heart disease, and arrhythmias. Even sudden cardiac death can occur.

How To Manage Tooth Grinding and Sleep Apnea

Because sleep apnea and sleep bruxism are two separate conditions, your healthcare team will likely treat each condition separately.

People with mild bruxism likely won’t need treatment. But if you’re damaging your teeth or experiencing other consequences, your dentist may recommend addressing the issue. Treatment options can include night guards for your mouth, muscle relaxants, or botulinum toxin injections.

If your healthcare provider or sleep medicine specialist suspects that you have obstructive sleep apnea, they’ll likely perform a sleep study. This can measure your oxygen levels and determine whether you have sleep-disordered breathing.

If you’re diagnosed with OSA, treatment usually begins with CPAP (continuous positive airway pressure) or another prescribed sleep apnea treatment. Some examples might include an oral appliance or a neuromuscular electrical stimulation device.

That said, some researchers have found that treating one condition may improve the symptoms of the other condition. For instance, one older study found that CPAP was successful in treating both conditions.

Meanwhile, some researchers found that oral appliances such as a mandibular advancement device (MAD) may help treat OSA and reduce bruxism. MADs pull the tongue and lower jaw forward. More research is needed before a single treatment is recommended for both conditions.

When To Contact a Healthcare Provider

Contact your dentist if you notice signs of teeth grinding or jaw clenching, such as flattened or worn teeth or persistent jaw pain. You don’t want to wait until you crack a tooth or have trouble chewing before you reach out for help.

Likewise, if you notice signs of sleep apnea or someone tells you that you snore, choke, or gasp for breath while sleeping, let your doctor know. You should also reach out for help if you’re tired during the day or have morning headaches.

Addressing these conditions early can help protect your sleep health. It can also protect you from complications like chronic health conditions or expensive dental work. Plus, ensuring you get the best sleep you can is extremely beneficial.

Not only can good sleep reduce stress and improve your mood, but you may also get sick less often and find it easier to maintain a healthy weight. Good sleep can even improve your heart health and metabolism.