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Review

Sleep Bruxism and Hypobaric Hypoxia Exposure: Exploring the Physiological Association

1
High Altitude Medicine Research Center (CEIMA), Arturo Prat University, Iquique 1100000, Chile
2
Faculty of Health Science, Arturo Prat University, Iquique 1100000, Chile
3
Health Division of the Chilean Army, Santiago 8340518, Chile
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(20), 7176; https://doi.org/10.3390/jcm14207176 (registering DOI)
Submission received: 28 August 2025 / Revised: 30 September 2025 / Accepted: 9 October 2025 / Published: 11 October 2025

Abstract

Sleep bruxism (SB) is a masticatory muscle activity during sleep which can be categorized as primary, when it remains unclear whether the phenomenon is directly linked to a specific disorder, or if it only coexists, and secondary, when it is proven to be associated with a particular disorder, treatment or lifestyle and bruxism that is part of the signs of a disorder. In this way, SB is associated with various factors, including obstructive sleep apnea and gastroesophageal reflux (GER), where evidence suggests SB has a protective role in airway patency, potentially triggered by microarousals and autonomic instability, especially under hypoxia conditions. Since hypobaric hypoxia exposition—generated by high-altitude exposure—produces a decrease in the partial pressure of oxygen, it triggers alterations in cardiac rhythm and gastric function, which could be associated with physiological alterations mentioned in SB. Therefore, the aim of this review is to determine the effect of hypobaric hypoxia exposure on the physiological and molecular alterations during sleep bruxism. Method: The SANRA-guided narrative review synthesized recent human and animal studies on hypoxia’s physiological and molecular effects in sleep bruxism. In conclusion, SB is associated with GER and autonomic dysregulation, which are present in hypobaric hypoxia conditions, where respiratory disturbances, microarousals, and increased muscle activity are associated with SB. High-altitude exposure triggers oxidative stress, genetics, and sleep alteration, which exacerbate its severity. Moreover, neurophysiological and molecular mechanisms, including TRPV1 and HIF-1α activation, are implicated. Finally, polysomnography remains the gold standard for diagnosis; however, studies at high altitude are needed to confirm this association.
Keywords: high altitude; bruxism; gastroesophageal reflux; hypoxia high altitude; bruxism; gastroesophageal reflux; hypoxia

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MDPI and ACS Style

Pena, E.; Yanez, M.P.; Montini, F. Sleep Bruxism and Hypobaric Hypoxia Exposure: Exploring the Physiological Association. J. Clin. Med. 2025, 14, 7176. https://doi.org/10.3390/jcm14207176

AMA Style

Pena E, Yanez MP, Montini F. Sleep Bruxism and Hypobaric Hypoxia Exposure: Exploring the Physiological Association. Journal of Clinical Medicine. 2025; 14(20):7176. https://doi.org/10.3390/jcm14207176

Chicago/Turabian Style

Pena, Eduardo, Maria Paz Yanez, and Francisca Montini. 2025. "Sleep Bruxism and Hypobaric Hypoxia Exposure: Exploring the Physiological Association" Journal of Clinical Medicine 14, no. 20: 7176. https://doi.org/10.3390/jcm14207176

APA Style

Pena, E., Yanez, M. P., & Montini, F. (2025). Sleep Bruxism and Hypobaric Hypoxia Exposure: Exploring the Physiological Association. Journal of Clinical Medicine, 14(20), 7176. https://doi.org/10.3390/jcm14207176

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