Probable sleep and awake bruxism in adolescents: A path analysis.

Background: Bruxism has a multifactorial etiology, including the influence of sleep characteristics and chronotypes.

Aim: To identify the pathways that influence the occurrence of probable sleep bruxism (PSB) and probable awake bruxism (PAB) in adolescents.

Design: A total of 403 adolescents, aged 12-19 years, participated in the study. Parents/caregivers filled out a questionnaire about sociodemographic issues and the adolescent's health conditions, and the adolescents about sleep characteristics, occurrence of bruxism (based on previous study and the International Consensus of Bruxism), and chronotype (Circadian Energy Scale). Clinical examinations were performed. Statistical analysis included descriptive analysis and path analysis.

Results: PSB and PAB are related to each other, with moderate and positive correlation (β = .390). Poor sleep quality and higher household income had a direct effect on both PSB (β = -.138; β = .123, respectively) and PAB (β = -.155; β = .116, respectively). Chronotype had a direct effect on PSB, in such a way that adolescents with a morningness chronotype tend to have PSB (β = -.102). Adolescents that drool on the pillow (β = .184) and/or have agitated sleep (β = .104) tend to have PSB.

Conclusion: Poor sleep quality, household income, morningness chronotype profile, drooling on the pillow, and agitated sleep influence the paths taken by PSB. PAB was influenced by the quality of sleep and family income.