Association between sleep bruxism and anxiety symptoms in adults: A systematic review

Abstract

Summary Background The purpose of this systematic review was to evaluate the association between sleep bruxism (SB) and anxiety symptoms in adults. Methods A systematic review was performed and studies assessing SB by means of questionnaires, clinical examination and/or polysomnography (PSG), and validated questionnaires to assess anxiety, were included. Search strategies were developed for seven main electronic databases. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross‐Sectional Studies, and confidence in cumulative evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation criteria. Results Eight cross‐sectional studies were included, of which five were judged with low and three with moderate risk of bias. No association with SB was observed in three studies that investigated generic levels of anxiety, while other two papers that evaluated generic anxiety levels through the State‐Trait Anxiety Inventory (STAI) found a positive association with probable and definite SB in both STAI‐1 and STAI‐2 subscales. Only one study evaluated dental anxiety in particular and an association with probable SB was observed regarding very anxious or extremely anxious scores. Two studies assessed specific symptoms of anxiety using the panic‐agoraphobic spectra evaluation (PAS‐SR) questionnaire. Significantly higher PAS‐SR total scores were observed in both studies with regard to SB. No study with definitive assessment of SB was identified. Conclusion Current literature is controversial regarding an association between SB and generic symptoms of anxiety in adults. It seems that some specific symptoms of the anxiety disorders spectrum might be associated with probable SB.

Emotional distress, psychosomatic symptoms and their relationship with institutional responses: A survey of Italian frontline medical staff during the Covid-19 pandemic

“…(2020) observed that high, uncontrolled stress affected the autonomic nervous system and cortex, potentially leading to psychosomatic and somatic symptoms, which in turn affect psychological problems. Somatic symptoms are hypothesised to represent a way of communicating emotions ( Kleinman, 1997 ) and a consequence of automatic stress responses ( Cavallo et al., 2014 ; Polmann et al., 2019 ), as found also in previous studies during the COVID-19 pandemic ( Almeida-Leite et al., 2020 ) and SARS ( Lam et al., 2009 ). Many factors may contribute to the expression of psychological distress via physical symptoms, such as professional role (i.e.…”

Bruxism: Best Evidence Consensus Statement

“…These factors included anxiety, 13,16,17 stress, 9,10,13,18 mood, 15 distress, 16 nervousness, 17 and feeling blue. 10 Polmann et al 19 provided their perspective in an SR that evaluated the association between SB and anxiety symptoms in adults. Despite the vast amount of literature available, only 8 cross-sectional studies met their very stringent inclusion criteria, 5 of which were judged to be with low and 3 with moderate risk of bias.…”

Association between sleep bruxism and stress symptoms in adults: A systematic review and meta‐analysis

“…Moreover, there are some comorbidities that may influence the variables of our SR, such as the presence of some anxiety symptoms 6 and the use of some psychotropic medications 8 . Studies that included participants with these conditions were excluded.…”

“…In healthy individuals, SB should not be considered as a disorder, but rather as a behaviour that can be a risk factor associated with certain clinical consequences. SB has a multifactorial aetiology, 1,2 that has been broadly classified into three groups of aetiological factors: biological factors, 3‐5 psychological factors such as anxiety symptoms 6 and exogenous factors such as consumption of some medicines, caffeine, tobacco and/or alcohol 7,8 …”