Bruxism, Teeth grinding in sleep

Bruxism (forceful teeth grinding during sleep) is thought to be the third most common parasomnia (partial arousal) experienced in the population. Parents notice this in their children and it can be a disturbing sound. Although parasomnia's tend to decrease in childhood, bruxism tends to remain for some children even at 13 years.

Approximately 20% of children are reported to grind their teeth during sleep and wake complaining of facial pains or headache. Stress has been considered to be a contributing factor but some studies have found no related day time stress reported in patients who grind their teeth.

Bruxism tends to be part of a chewing and swallowing process and a study in 2003 postulated that children with reflux may experience bruxism as a secondary effect along with increased saliva production. Sleep position also has an effect on the level and frequency of bruxism.

In 2008 further work on sleep disordered breathing showed a positive reduction in bruxism following tonsil and adenoid removal. Randomised Controlled Trials of occlusive dental splints have not conclusively demonstrated this device is sufficently effective in resolving sleep issues, although they may reduce wear and tear on teeth.

Perhaps the assessment of children with bruxism by Ear Nose and Throat Specialists would be worthwhile, particularly for those for whom sleep disordered breathing is an issue? There seems to be no current consensus on how best to resolve this parasomnia. Some authorities believe children may outgrow this but there remains an adult population who also experience bruxism.

Further research should lead to a better overview of both causes and the identification of effective treatment.

Parasomnias

Parasomnias are unusual behaviours or strange experiences, which occur mainly or only when going to sleep, during sleep or when waking up. Parents are often very concerned about these events, however they do not mean that the child is psychologically disturbed or medically ill in any way. Very often these events will stop after some time and without any intervention but sometimes safety measures must be taken to protect the child. For example in sleep walking it is useful to ensure that the child does not injure themselves.

There are currently over 30 types of recognised Parasomnias in two main groups.

Primary Parasomnias can be grouped according to the time of night when they occur.

Secondary Parasomnias are the expression of underlying medical, behavioural or psychiatric conditions. Nocturnal epilepsy, nocturnal panic attacks

Parasomnias occur at all ages but are more common in children than in adults. Children may have more than one type of parasomnia as they may also have more than one type of sleep disorder. Sleep apnoea can be associated with sleep walking for example.

It is very important that the parasomnias are correctly identified as the treatment and interventions required are dependant on this. Accurate identification depends on a detailed account of the experiences both from a subjective and objective sequence of events, the timing of the event and the cicumstances in which the event occured. Audio visual recording, in the form of home video can be very helpful in this.

Specific medication is usually only required in a minority of primary parasomnias but may be required to treat the underlying problem in secondary parasomnias.
Research information on Parasomnias is quite limited at the moment.

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