Sleep Study for Bruxism: A Complete Guide
Bruxism occurs when an individual tenses their jaw muscles repeatedly, thereby grinding and clenching their teeth. This behavior produces an audible sound that can be disruptive to bed partners. While bruxism may happen during waking hours, it usually occurs during sleep and is sometimes known as sleep-related bruxism.
As a leading provider of dentist-recommended mouthguards, we discuss the causes of bruxism and the importance of sleep study:
What causes bruxism?
While the causes of bruxism aren’t clear, research suggests some factors may increase the probability that an individual may experience nighttime tooth grinding:
Loud snoring
Research suggests a correlation between sleep-related bruxism and snoring.
Personality type
Individuals who are extremely motivated or competitive may have a greater frequency of sleep-related bruxism.
Alcohol, tobacco, or caffeine use
Individuals who use tobacco or drink alcohol/caffeine frequently are likelier to experience bruxism.
Genetics
While there’s no definitive connection between bruxism and genes, one in two people with this condition has at least one close family member who grinds their teeth.
Neurologic and mental health conditions
Some health conditions are associated with bruxism, including cerebral palsy, Rett syndrome, down syndrome, ADHD, and certain psychiatric disorders.
Stress and anxiety
Bruxism is more common in people who experience a lot of stress and anxiety. Some people report that they grind their teeth more frequently during stressful situations.
Sleep disorders
People with sleep disorders like parasomnia or obstructive sleep apnea are more likely to develop bruxism.
When to see a dentist?
Waking up with tooth pain, jaw pain, or headaches, or having a bed partner who has heard you grinding your teeth are all signs that calling your dentist or doctor may be helpful. Similarly, if you hear a grating sound frequently while your partner is asleep, it’s time to visit the doctor.
In addition, if you have previously been diagnosed with sleep disorder and are experiencing bruxism-related symptoms, you should see a dentist.
How is bruxism diagnosed?
Doctors may typically diagnose bruxism based on an individual's symptoms. The sound of teeth grinding, combined with jaw/dental issues, typically suggests that a person has bruxism.
Doctors may typically diagnose bruxism based on an individual’s symptoms. The sound of teeth grinding, combined with jaw or dental issues, often suggests that an individual has bruxism.
While testing isn’t needed to diagnose sleep-related bruxism, doctors can perform tests to rule out other sleep disorders and conditions. If a healthcare provider feels that testing must be done, they may recommend a sleep study.
While sleep studies aren’t very effective in detecting occasional/mild episodes of the behavior, they’re accurate at diagnosing more serious cases of bruxism.
In some cases, doctors may recommend that an individual undergo at-home testing to determine if they have bruxism. However, a sleep study is always better than home testing because a technician monitors the former.
What is a sleep study?
A PSG (polysomnogram)comprises multiple sets that measure physical functions related to sleep. These tests normally comprise:
Microphone
A microphone near the sleeper picks up snoring sounds.
Plethysmographic strain belts and airflow sensors
Sensors near the mouth and nose measure airflow, and belts are strapped around the abdomen and chest to monitor movements associated with breathing effort.
Electrooculography
This measures eye movements to help researchers estimate sleep stages.
Pulse oximetry
This device can be attached to the toe, earlobe, or finger to measure blood oxygen levels.
EKG (electrocardiography)
An EKG uses electrodes stuck to the skin and measures electrical impulses in the heart. They can identify elevated and slow heart rates and irregular heart rhythms.
Electromyography
This test monitors and analyzes muscle contractions.
EEG (Electroencephalography)
This measures and records brain waves during sleep to determine how long the person spends in every sleep stage.
Why are sleep studies conducted?
Sleep studies are used to diagnose or rule out disorders like:
- Sleep-related movement disorders like periodic limb movement disorder
- REM (rapid eye movement)sleep behavior disorder
- Nocturnal seizures
- Narcolepsy
- Sleep apnea, as well as other sleep-related breathing disorders
Doctors may also go through polysomnography results to determine if someone has restless legs syndrome. While polysomnography isn’t generally used for circadian rhythm sleep-wake disorders, the results may draw attention to discrepancies that indicate abnormal sleep rhythms. Likewise, doctors may order polysomnography to help diagnose teeth grinding (sleep bruxism) or parasomnia, such as sleepwalking, even if there’s no need for a sleep study.
For people with sleep apnea, polysomnography can be performed while wearing a PAP (positive airway pressure) device. These devices supply airflow with pressure to keep the airway open. This test is conducted to determine the best pressure for every individual.
What to expect during a sleep study?
Typically, full sleep studies are performed in labs that resemble hotel rooms, with regular beds to help you feel comfortable and relaxed. You usually arrive at the sleep center about a couple of hours before your usual bedtime with the intention of sleeping there overnight (or during the day if you work night shifts).
Before you go to bed, a technician attaches the pulse oximeter, airflow sensors, breathing belt, and electrodes. While you’re asleep, technicians monitor your breathing patterns and heart rate. While the sensors aren’t painful, you may experience some irritation that should disappear once the study is complete. The PSG may also be recorded to allow a specialist to analyze your movements visually. Typically, the duration of sleep studies is the same as a normal night of sleep.
If your doctor thinks that your obstructive sleep apnea is at a modern to severe level, you may be able to perform a sleep study at home. Since in-home testing involves fewer sensors, it’s not appropriate for diagnosing other medical conditions or sleep disorders. While the test can be performed at home with relative ease, the results are still interpreted by a sleep specialist before a diagnosis is made.
What if I can’t sleep during a sleep study?
According to sleep specialists, some people have difficulty falling asleep on the first night in a sleep laboratory. Talk to your technician or doctor beforehand if you’re concerned about falling asleep during your sleep study.
If possible, avoid drinking alcohol or caffeine before the study commences. You should also refrain from taking sleep medication.
What may sleep study results indicate?
Besides physiological data like breathing effort and heart rate, polysomnography offers information about nighttime awakenings, total sleep time, the time spent in every sleep stage, and how long it takes you to fall asleep. Once the sleep study is complete, a specialist reviews the results to see if they hint towards an underlying sleep disorder.
For instance, they may diagnose you with sleep apnea if you stop breathing in your sleep regularly. Similarly, they may consider a diagnosis of periodic limb movement disorder if they observe excessive leg movements during sleep. For people who talk during dreams or display physical movements, the specialist may identify a case of REM (rapid eye movement) sleep behavior disorder.
Based on the findings, your healthcare provider may work alongside you to draft a treatment plan or refer you to another specialist for more testing.
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