The Hidden Connection Between Teeth Grinding and Sleep Apnoea: What You Should Know Before Getting a Night Guard
If you've been told you grind your teeth at night—or if you've noticed jaw pain, worn teeth, or your partner hears grinding sounds while you sleep — you might assume a simple night guard is all you need. But the latest research and clinical guidelines suggest it may not be that simple.
Emerging evidence shows a significant overlap between nocturnal bruxism (teeth grinding during sleep) and obstructive sleep apnoea (OSA)—a serious condition where the airway becomes partially or completely blocked during sleep. Treating the teeth grinding without first screening for sleep apnoea could mean missing the underlying cause and delaying the right treatment.
At Sleep Matters, we specialise in identifying and treating the root causes of sleep-related dental issues, not just the symptoms. Here's what current research and guidelines from the Australian Sleep Association (ASA), Australian Dental Association (ADA), American Academy of Dental Sleep Medicine (AADSM), and the New Zealand Dental Association (NZDA) tell us about the link between bruxism and sleep apnoea—and why it matters to your health.
What Is Sleep Bruxism?
Sleep bruxism is a condition characterised by repetitive clenching or grinding of the teeth during sleep. It’s considered a sleep-related movement disorder and can lead to:
Flattened or worn-down teeth
Jaw muscle fatigue or tightness
Tooth fractures
Morning headaches
Disrupted sleep—for both the person grinding and their bed partner
Traditionally, dental professionals have managed bruxism with night guards or bite splints—custom-made devices designed to protect the teeth from further damage. However, newer research suggests that in some cases, bruxism is not just a mechanical problem—it may be a physiological response to sleep-disordered breathing.
What Is Obstructive Sleep Apnoea (OSA)?
Obstructive sleep apnoea is a common sleep disorder where the airway repeatedly collapses or becomes blocked during sleep, reducing or completely stopping airflow for short periods.
Common symptoms include:
Loud, chronic snoring
Gasping or choking sounds at night
Unrefreshing sleep or insomnia
Morning headaches
Difficulty concentrating during the day
Excessive daytime sleepiness
Left untreated, OSA increases the risk of serious health problems, including high blood pressure, type 2 diabetes, cardiovascular disease, and even stroke.
The Evidence-Based Link Between Bruxism and OSA
Recent studies suggest a strong relationship between sleep bruxism and OSA revealing that up to 50% of patients with OSA also experience sleep bruxism, particularly in moderate to severe cases. The AADSM, ASA, and ADA all recognise this co-occurrence and recommend careful evaluation of both conditions before initiating treatment.
So what’s the connection?
It's believed that bruxism may be a protective mechanism. When the airway narrows or collapses, the body responds by triggering a brief arousal (awakening) —often accompanied by a burst of jaw activity. This involuntary movement may help reopen the airway, restoring normal breathing. In this context, grinding isn’t the primary problem—it’s a symptom of a more serious underlying issue.
Why Dentists Should Always Screen for Sleep Apnoea Before Prescribing a Night Guard
The Australian Dental Association (ADA) and NZDA both encourage dentists to screen patients for signs and symptoms of sleep-disordered breathing before delivering any oral appliance, including bite splints or night guards.
This is echoed by the AADSM, which states that dentists play a frontline role in identifying sleep apnoea risks and referring patients for further evaluation.
Here's why that matters:
A traditional night guard may protect teeth from wear but won’t address airway obstruction.
In some cases, night guards may actually worsen airway collapsibility if they reposition the jaw or tongue unfavourably.
Failing to identify OSA can result in delayed treatment, allowing health risks to progress unchecked.
Oral Appliance Therapy: Treating Both Bruxism and OSA
If a patient is diagnosed with both bruxism and OSA, oral appliance therapy can be an ideal solution. These custom-made devices—also known as mandibular advancement splints (MAS)—are worn during sleep to gently reposition the lower jaw forward. This slight repositioning helps:
Keep the airway open, preventing apnoea episodes
Reduce or eliminate snoring
Minimise the grinding response associated with arousal
Multiple studies have confirmed that oral appliances not only reduce OSA symptoms but can also decrease the frequency and intensity of bruxism episodes.
At Sleep Matters, we focus on evidence-based appliance therapy that supports both airway patency and dental protection. Each device is carefully customised based on your jaw anatomy, airway needs, and sleep study results.
Sleep Matters Clinic: The Expert Choice for Dental Sleep Medicine in Wellington
Sleep Matters is one of the few dental clinics in New Zealand with a dedicated focus on dental sleep medicine. Our team, led by Dr Jess—a dentist with advanced training in sleep-disordered breathing—works closely with GPs, sleep physicians, and allied health professionals to ensure every patient receives the right diagnosis and the most effective treatment.
Whether you're concerned about snoring, sleep apnoea, or have been told you grind your teeth at night, our priority is getting to the root of the issue, not just managing the symptoms.
What Should You Do if You Grind Your Teeth at Night?
If you're considering a night guard or have noticed signs of bruxism, follow these evidence-backed steps:
Get screened for OSA—especially if you snore, feel excessively tired during the day, or have other risk factors.
Avoid over-the-counter or one-size-fits-all night guards. These may provide short-term protection but won’t address the root cause and could worsen symptoms in patients with OSA.
Consult a dental sleep medicine expert for a comprehensive evaluation.
Request a referral for a sleep study if OSA is suspected. This is the gold standard for diagnosis.
Conclusion: Don’t Ignore the Bigger Picture
Tooth grinding may seem like a minor nuisance, but it can often be a signal of an underlying sleep disorder. Before you accept a night guard as the solution, make sure you’ve been properly assessed for sleep apnoea.
By choosing an expert-led, evidence-based approach like the one at Sleep Matters, you’re not just protecting your teeth—you’re protecting your health and your quality of sleep.