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Adults with obstructive sleep apnea syndrome appear more likely to experience sleep bruxism, suggesting a potential bidirectional association

An umbrella review of eight systematic reviews found frequent coexistence of sleep bruxism and obstructive sleep apnea syndrome (OSAS) in adults, possibly due to shared mechanisms like micro-arousals and autonomic activation. Only one review included a meta-analysis, and most reviews had low or critically low methodological quality. The evidence is heterogeneous and limited, with causality remaining unclear.

Last updated: Jul 17, 2026•0 RCTs•1 Meta-analyses•📖 Read as article →

Evidence Score

Evidence Score47/100
Human RCT☆☆☆☆☆
Meta-analysis★★★☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Possible association between obstructive sleep apnea syndrome and sleep bruxism in adults: an umbrella review.

observational

Pereira KK, Pereira IF, Machado Júnior AJ · Sleep medicine (2026)

Participants: N/A
Duration: N/A
Intervention: Assessment of association between OSAS and sleep bruxism via systematic review of existing literature
Outcome: Coexistence and bidirectional relationship between OSAS and sleep bruxism
Effect Size: N/A
Population: Adults with obstructive sleep apnea syndrome and/or sleep bruxism

Result:

PubMed: 42447651DOI: 10.1016/j.sleep.2026.109129

Mechanism Graph

Micro-arousals during sleep occur in OSAS
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Micro-arousals trigger autonomic nervous system activation
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Autonomic activation leads to rhythmic masticatory muscle activity
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Result: Increased likelihood of sleep bruxism episodes in OSAS patients

Limitations

  • ⚠Most included systematic reviews had low or critically low methodological quality
  • ⚠Only three reviews had low risk of bias, and evidence was heterogeneous and limited
  • ⚠Causality remains unclear due to lack of well-designed randomized and longitudinal studies

Frequently Asked Questions

What is the main finding of this umbrella review?▼

The review found that adults with obstructive sleep apnea syndrome (OSAS) appear more likely to experience sleep bruxism, suggesting a potential bidirectional association, though causality is not established.

How many systematic reviews were included in this umbrella review?▼

Eight systematic reviews were included, only one of which contained a meta-analysis.

What mechanisms might link OSAS and sleep bruxism?▼

Shared mechanisms such as micro-arousals and autonomic activation during sleep are proposed as possible links between the two conditions.

What are the limitations of the evidence in this review?▼

The evidence is heterogeneous and limited, with most reviews having low or critically low methodological quality, and only three reviews had low risk of bias.

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References

  1. 1.Pereira KK, Pereira IF, Machado Júnior AJ. "Possible association between obstructive sleep apnea syndrome and sleep bruxism in adults: an umbrella review.." Sleep medicine, 2026. PMID: 42447651 DOI: 10.1016/j.sleep.2026.109129
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.