Possible association between obstructive sleep apnea syndrome and sleep bruxism in adults: an umbrella review.
Level 1 - systematic review of randomized trials
Umbrella systematic review of systematic reviews
PubMed 42447651 · doi:10.1016/j.sleep.2026.109129
What was done
An umbrella systematic review following PRISMA 2020 evaluated the evidence for a bidirectional relationship between obstructive sleep apnea syndrome (OSAS) and sleep bruxism in adults. Six databases (PubMed, LILACS, BVS, SciELO, Scopus, Embase) were searched from 2000 to January 2026 for systematic reviews (with or without meta-analysis) using polysomnography-based diagnostic criteria. Methodological quality was evaluated using AMSTAR-2 and risk of bias was assessed with ROBIS.
What was found
Out of 1,726 identified records, 8 systematic reviews met the inclusion criteria (only 1 included a meta-analysis). Specific quantitative pooled effect sizes were not reported in the abstract. Most reviews reported a frequent coexistence of sleep bruxism and OSAS, potentially mediated by shared mechanisms such as micro-arousals and autonomic activation, though causality remains unestablished. Methodological quality across the included reviews was mostly low or critically low, and only 3 of the 8 reviews exhibited a low risk of bias.
Why it matters
Understanding the overlap between sleep apnea and bruxism can assist clinicians in identifying co-occurring sleep-related disorders that exacerbate dental damage and airway obstruction. However, current evidence is too methodologically weak to confirm causality or guide definitive combined treatment pathways.
Limits
The review relies on secondary synthesis of existing reviews rather than primary data, inheriting all biases of the underlying literature. Only one included review conducted a meta-analysis, preventing quantitative synthesis. Methodological quality across most included systematic reviews was low or critically low according to AMSTAR-2, and observational designs in the primary studies prevent determination of a true bidirectional or causal relationship.
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- supports Teeth grinding (bruxism) can be a physical signal of airway obstruction or sleep-disordered breathing.