SLEEP BRUXISM IS AN INVOLUNTARY MANDIBULAR MOVEMENT WITH TOOTH GRINDING OR CLENCHING OCCURRING DURING SLEEP THAT CAN LEAD TO several dental, oral, and facial complications.1 According to the American Academy of Sleep Medicine, the diagnosis of sleep bruxism

SLEEP BRUXISM IS AN INVOLUNTARY MANDIBULAR MOVEMENT WITH TOOTH GRINDING OR CLENCHING OCCURRING DURING SLEEP THAT CAN LEAD TO several dental, oral, and facial complications.1 According to the American Academy of Sleep Medicine, the diagnosis of sleep bruxism is based on the report of tooth grinding or clenching in combination with at least 1 of the following signs: abnormal tooth wear, sounds associated with bruxism, and jaw muscle discomfort.2,3 Sleep bruxism is reported in up to 20% of children younger than 11 years of age.1 This is probably an underestimate and may indicate only clinically significant bruxism. The prevalence decreases with age. Polysomnography studies in adults have investigated the sleep architecture in patients with bruxism. Whereas most adult studies have found no difference in the percentage of different sleep stages in patients with bruxism as compared with controls,3-5 others have reported a shorter rapid eye movement (REM) latency, a decreased percentage of REM sleep, and an increase in the number of sleep transitions.6 Adult studies have shown that sleep bruxism occurs mainly during stages 1 and 2 of non-REM sleep and REM sleep and to a lesser degree in stage 3 and 4 of non-REM sleep.1,5,7 In adults, episodes of sleep bruxism are frequently accompanied with brief arousals.1,5 In addition, a recent study in adults has linked bruxism with gastroesophageal reflux disease (GERD).8,9 Frequent arousals in children related to obstructive sleep apnea have been correlated with problems in behavior regulation, attention, and executive functioning.10 To our knowledge, however, there has been no study to evaluate the sleep architecture, incidence of arousals, relationship to GERD, or daytime cognitive and behavior functions in children with bruxism. The objectives of this study are to investigate the sleep architecture of children with bruxism, to evaluate the presence of GERD as a cause of bruxism, and to assess the daytime behavior and cognitive impact of bruxism.