Association between possible bruxism, sleep quality, depression, anxiety and stress by gender. A cross-sectional study in a Spanish sample.

OBJECTIVE: To explore the associations between possible bruxism, sleep quality, depression, anxiety and stress, with a specific focus on gender differences. MATERIAL AND METHODS: An online questionnaire was administered to 400 Spanish-speaking participants, without cognitive impairments. The survey included the possible bruxism self-perception test of Lobbezoo et al., the Pittsburgh Sleep Quality Index, and the Depression, Anxiety, and Stress Scale-21 (DASS-21). Participants were recruited using a "snowball" sampling technique over a five-month period in 2024. The Chi-square test and the Fisher-Freeman-Halton exact test were used for statistical analysis. The significance level was set at 0.05. RESULTS: Possible bruxists made up 25.4 % of women (n = 67) and 14.7 % of men (n = 20), with a statistically significant difference (P = 0.019). Depression was present in 30.0 % of participants (33.0 % of women and 24.3 % of men; P = 0.072), anxiety in 30.7 % (36.0 % of women and 20.6 % of men; P = 0.002), and stress in 29.0 % (33.3 % of women and 20.6 % of men; P = 0.008). No significant association was found between possible bruxism and emotional disorders in men, whereas a strong association was observed in women (P < 0.001). Similarly, no statistically significant relationship was found between possible bruxism and sleep quality in either gender. However, poor sleep quality was more common among women than men (54.6 % vs 43.7 %; P = 0.040). CONCLUSIONS: Poor sleep quality, anxiety, stress and depression and possible bruxism are more frequent among women. While no association between possible bruxism and emotional disorders was found in men, a significant relationship was observed in women. Furthermore, although no direct association between possible bruxism and sleep quality was detected, sleep quality was significantly associated with emotional disorders in both genders. CLINICAL RELEVANCE: These findings suggest that emotional disorders may contribute to the development of possible bruxism in women but not in men. Therefore, women with emotional disorders should be closely monitored, as they are particularly susceptible to possible bruxism and poor sleep quality. Dentists play a crucial role in diagnosing possible bruxism and identifying patients who may benefit from psychological support.