Suffering from temporomandibular joint (TMJ) disorder comes with its own headaches (literally), but if you have TMJ and sleep apnea, your sleepless nights can be especially challenging. Knowing how to manage both TMJ and sleep apnea can help. Here’s what you should know.
What’s the relationship between TMJ and sleep apnea?
Temporomandibular joint disorder (interchangeably referred to as either TMJ or TMD) is a condition that occurs when the joint that forms the hinge between your lower and upper jaw becomes inflamed and painful.
TMJ most commonly develops when people chronically grind and clench their teeth, but it can also be a result of injury or other medical conditions.
Common symptoms of TMJ include:
- Pain in the jaw
- Headache
- Stiffness and soreness in the morning
- Shoulder and upper back pain
- Clicking or popping in the joint
- Reduced range of motion
Sleep apnea is a type of sleep-disordered breathing characterized by pauses in the breath followed by a gasping intake of air. There are three types of sleep apnea that affect an estimated 25 million people in the U.S. These include:
- Obstructive sleep apnea: The most common form that occurs when the muscles of the tongue and throat relax back, blocking the airway
- Central sleep apnea: A neurological condition where the brain “forgets” to breathe
- Complex sleep apnea: A dangerous combination of the first two, where the airway is blocked but the brain does not reflexively breathe
Sleep apnea causes daytime sleepiness and difficulty concentrating. Left untreated, sleep disordered breathing can also increase your risk of serious health conditions.
An estimated 25% of obstructive sleep apnea patients also grind their teeth at night, a condition that can lead to TMJ. Other research has found that patients with sleep apnea were twice as likely to develop TMJ. Another review of studies found that sleep bruxism (teeth grinding and jaw clenching at night) was a companion to sleep apnea, and that each could make the other condition worse.
Can TMJ cause sleep apnea?
While it’s hard to determine which has more influence on the other, the connection between TMD and sleep apnea is persistent and clear.
TMJ may not be a direct cause of sleep apnea, but the two conditions share common risk factors, and, as we discuss below, treating one can often help reduce symptoms of the other.
Challenges of TMJ and sleep apnea
TMD affects an estimated 44 million people in the U.S., a number which may be underreported for a variety of reasons. Women are more affected than men in general. With sleep apnea, the demographic is reversed, with men reporting sleep disordered breathing more than women.
Even as these rates of incidence may be low estimates, many people with TMJ have difficulty complying with their treatments for sleep apnea.
The first line treatment for moderate to severe sleep apnea is a continuous positive airway (CPAP) machine. This machine uses a mask fitted over the mouth, nose, or both to deliver a stream of air to the back of the throat. This keeps the airway open and can reduce or eliminate the symptoms of sleep apnea.
A CPAP machine comes with drawbacks when it comes to treating sleep apnea secondary to TMJ, though. The first issue is with compliance. Many patients find the mask uncomfortable and too noisy for sleep. They may complain of dry mouth and dental issues due to the air in their mask all night. It also places pressure on the face, increasing overall aches and pains.
Additionally, a CPAP machine does not address the issue of TMD. A patient may continue to grind and clench their teeth all night, eventually abandoning the CPAP machine and continuing to suffer the potentially life-threatening effects of sleep apnea.
Some patients may choose to move to a dental device to manage both their sleep apnea and TMJ, but then stop using that due to a sore jaw. However, it is possible to treat both conditions comfortably and effectively, and the solution lies in a great dentist.
Managing TMJ and sleep apnea
It’s no secret that CPAP machine compliance is generally low. A 2008 study found that almost half of all sleep apnea patients diagnosed with severe obstructive sleep apnea either abandoned the CPAP machine after less than a year or never started treatment at all.
The best treatment option is the one that a patient will comply with. For that reason, a sleep apnea dental device, fitted by an experienced dentist, can help many patients. This device gently holds the jaw open and forward to keep the airway clear all night.
For patients with jaw pain due to a concurrent TMJ diagnosis, this device needs to be fitted carefully to make it more comfortable. At AZ Dentist, we follow the American Academy of Sleep Medicine’s guidelines to carefully titrate your dental device. We adjust each appliance in small increments over time to gradually support a healing jaw and offer the most comfortable fit.
Imagine you are trying to touch your toes but have not done so in years. You wouldn’t force yourself to reach the ground for fear of injury; instead, you would go slowly and take your time to reach your toes.
The same goes for sleep apnea dental devices if you have TMJ. We fit your device carefully and adjust it over time to gradually support your treatment without worsening symptoms of TMJ. It’s like doing yoga for your jaw pain, gradually stretching over time. With the right fit, it can also help you manage your TMJ symptoms.
Working with your dentist to treat both sleep apnea and TMJ can ease symptoms of both to help you get a good night’s rest. Get in touch with AZ Dentist to see how we can help!