Sleep Apnea and TMJ

Sleep apnea is a complex condition that can greatly affect an individual’s sleep quality. There can be many causes of sleep apnea, and one of them is TMJ. TMJ, which is short for the temporomandibular joint, is the hinge that connects your jaw to your skull. If you are having issues with TMJ and are sleeping poorly because of it, keep reading to learn more about sleep apnea and TMJ and what you can start doing today for a better night’s sleep.

Sleep Apnea and TMJ: What is TMJ?

As mentioned, TMJ is short for the temporomandibular joint. The temporomandibular joint and muscle disorder affects between 5% and 12% of people and TMJ disorders are at least twice as prevalent in women as men. The interesting thing about TMJ is that there is no standard definition. It can be diagnosed by asking about simple symptoms and the prevalence of them.

The temporomandibular joint is moved by four different muscles. These are the:

• Masseter
• Medial pterygoid
• Lateral pterygoid
• Temporalis

These four muscles, all linked to the nerve V3 (also known as the mandibular division of the trigeminal nerve), work in different groups to be able to move the jaw in different directions. When one of these muscles is affected, it can cause a chain reaction to the other groups that now need to work harder to make up for it. This can cause a host of issues that become TMJ disorders.

What Causes TMJ?

• Injuries to the jaw. If you experience an injury to your jaw, it is likely that you will have TMJ issues, even after the injury is healed. This can also include surgery, such as dental work.
• Arthritis. Arthritis is a debilitating condition that affects joints, and this includes the jaw.
• Teeth grinding. You may not even realize you do it, but if your jaw is in pain when you wake up – that is because it has been hard at work all night. This overuse of the jaw muscles can cause TMJ.
• Infected teeth. Tooth decay can cause infection, which can spread to the jaw and cause issues with the TMJ muscle group.
• Sinus infections. When the sinuses become too inflamed, they can begin affecting other areas of the face, including the jaw.
• Autoimmune diseases. Conditions such as lupus, sclerosis, or rheumatoid arthritis can cause TMJ.
• Poor posture. It’s true! The skeleton is all interconnected, and poor posture can affect the entire body, even the jaw.

Symptoms of TMJ Disorders

Symptoms of TMJ Disorders include:

• Jaw pain, especially when chewing, speaking, or yawning
• Jaw pain that is most prevalent in the morning and can be described as a dull throbbing
• Popping, clicking, or grinding sounds due to the mandibular disk being out of place
• Difficulty moving the jaw due to stiff jaw muscles
• Pain radiating to the rest of the face, making eating and talking difficult
• Frequent headaches or migraines
• Earaches
• Toothaches
• Muscle spasms or twitching
• Tinnitus
• Bite misalignment
• Inflammation of the face and neck
• Eye discomfort

Effects of TMJ Disorders

If left untreated, TMJ disorders can cause long-lasting effects. These include:

• Migraines. Due to other parts of the face becoming overworked to compensate for the damaged TMJ muscle, migraines are a very common effect of TMJ disorders. Migraines can be debilitating and can affect almost every area of your life.
• Hearing loss. The TMJ muscles are located very close to the ear and ear canal. When the jaw muscles become inflamed, it can cause issues to the ear. Some of these include tinnitus, hearing loss, and other damages.
• Sleep apnea. It is very common for individuals suffering from TMJ disorders to also suffer from sleep apnea.

Treatments for TMJ

Unfortunately, there is no simple medication that can be prescribed for TMJ disorders. It is complex and unique to each individual who suffers from it, and what may work for one person might not work for another. Treatments for TMJ include:

• Exercises. Gentle stretches and exercises of the jaw muscles can help ease them back into their normal functions, while also helping to alleviate pain.
• Ice and heat. By reducing the inflammation of the jaw muscles, ice and heat can help reduce symptoms of TMJ.
• Anti-inflammatory medication. Similar to ice and heat, anti-inflammatory medication can help reduce the pain and symptoms of TMJ disorders.
• Avoiding triggers. TMJ can become exacerbated by overuse of the jaw muscles. By avoiding exacerbations, symptoms can become greatly reduced. This includes avoiding chewing gum, teeth grinding, and more.
• Dental splints. By essentially “training” the jaw muscles to return back to their normal, natural position, regular use of a dental splint can help ease TMJ disorders.
• Botox injections. Botox is an injectable medication to relax the muscles. Using Botox for TMJ treatment will help ease discomfort, pain, and avoid overuse of the jaw.

What is Sleep Apnea?

Sleep apnea is defined as a condition marked by abnormal breathing during sleep. People with sleep apnea have multiple extended breathing pauses when they sleep. These temporary breathing lapses cause lower-quality sleep and affect the body’s supply of oxygen, leading to potentially serious health consequences.

Although sleep apnea is very common, it is a dangerous condition that can extend to almost every area of an individual’s life. The tricky part about sleep apnea is that an individual may have no idea they suffer from it, unless they are able to recognize the signs and symptoms or have a partner who alerts them of their abnormal breathing. In fact, of the estimated 22 million Americans who suffer from sleep apnea, 80 percent of the cases of moderate and severe obstructive sleep apnea are undiagnosed.

Signs and Symptoms of Sleep Apnea

• Snoring. One of the most tell-tale signs of sleep apnea is loud snoring. This is a clear sign that there is an obstruction in the airway which is causing the loud mouth breathing.
• Gasping for air. If your partner tells you that you go through periods of not breathing, holding your breath, and gasping for air during sleep, these are all signs of sleep apnea.
• Issues with sleep. Insomnia, nightmares, or frequent awakenings to urinate are also symptoms of sleep apnea.
• Daytime drowsiness. Everyone feels tired every once in a while. However, if you are feeling excessively drowsy and fatigued every day, this could be because you are not receiving quality, restorative sleep at night due to sleep apnea. Fatigue can also lead to difficulty concentrating or paying attention at work or school.
• Weight gain. Individuals who are suffering from daytime drowsiness may not have the energy to exercise and eat healthily during the day, which can lead to weight gain. In addition, the lack of oxygen going through the body due to the episodes of paused breathing can cause weight gain.
• Mood swings. Depression and irritability are very good friends with sleep deprivation and fatigue. Experiencing frequent mood swings is a very common symptom of sleep apnea.
• Mouth and throat dryness. Individuals who suffer from sleep apnea commonly experience a dry mouth, dry throat, or sore throat when they wake up in the morning due to excessive mouth breathing.

Types of Sleep Apnea

1. Obstructive sleep apnea (OSA): OSA occurs when the airway at the back of the throat becomes physically blocked. That obstruction causes temporary lapses in breath.
2. Central sleep apnea (CSA): CSA happens because there is a problem with the brain’s system for controlling muscles involved in respiration, leading to slower and shallower breathing.
3. Mixed sleep apnea: When a person has both OSA and CSA at the same time, it is referred to as mixed sleep apnea or complex sleep apnea.

The Link Between Sleep Apnea and TMJ

When an individual is suffering from obstructive sleep apnea, the airway is blocked and the body gets into survival mode. In order to keep breathing, the body pushes the jaw forward in order to open up the airway. As this happens repeatedly throughout the night, it can cause unnecessary stress to the TMJ muscles and potentially lead to TMJ disorders.

Alternatively, existing TMJ disorders can exacerbate sleep apnea. Having the proper jaw placement is essential to a great night’s sleep, and when an individual has a misaligned jaw due to TMJ disorders, it can lead to sleep apnea.

It can be impossible for many people to figure out which came first: their TMJ disorder or their sleep apnea. This is why it is very important to find a treatment plan that can help treat both, so that one does not exacerbate the other.

Treatments for Sleep Apnea

CPAP Machine

When people hear “sleep apnea”, they often think of a CPAP machine. This medical device works by providing more oxygen through the airways at a greater pressure. This offers the user a better night’s sleep, less snoring, and eases all of the symptoms of sleep apnea.

However, many individuals suffering from sleep apnea do not want to go through the process of dealing with a CPAP machine. They can be expensive, loud, and difficult to get used to, uncomfortable on their face in certain sleeping positions, and difficult to travel with. They can disturb the user’s partner, and they can be tedious to keep clean or repair.

Surgery

With severe cases of obstructive sleep apnea, surgery may be a great option. By removing the obstruction, the individual will be able to have a more restful and restorative night’s sleep. Surgery should only be considered if all other options have been exhausted.

Oral Appliance

One way to treat sleep apnea and TMJ together is by using an oral appliance. An oral appliance will prevent the tongue from blocking the throat, or move the lower jaw forward, or both. By having proper jaw placement, you can train your TMJ muscles while also clearing the obstruction that causes your snoring.

Exercises

Another way to treat both sleep apnea and TMJ at the same time is to try exercises, also known as Myofunctional Therapy. These exercises will help strengthen the jaw over time — just like “working out” any other muscle in the body! They help the muscles not only strengthen but adjust back to their natural resting place. Improper tongue and jaw resting posture can lead to a host of issues other than sleep apnea and TMJ. These include:

• Dental issues such as crowding, grinding, or decay
• Neck pain
• Jaw pain
• Flatter face shape
• Bad posture

How to Fix Sleep Apnea and TMJ Today

If you are ready to tackle your sleep apnea and TMJ issues, we can help. As a highly trained dentist in the treatment of TMD, Dr. Martin Gorman has spent years learning and practicing the most advanced technology and research to bring relief to TMD patients. The heart of our practice is to help you find freedom from TMJ and related symptoms—especially TMJ tension headaches and migraine headaches.

Dr. Gorman’s firm commitment to his patients is to provide relief from migraine headaches, teeth grinding, jaw popping and clicking, ringing in ears, as well as any jaw, face, head, or neck pain related to TMJ. His approach is a comprehensive program for treating all TMJ issues.

Learn more and get in touch with us at mgormandental.com.