11 Jun Sleep
What’s the Connection? TMJ and Sleep
Did you know that many patients who suffer from sleep disorders are also dealing with a problem directly related to disorders in their temporomandibular joint (TMJ)?
If you are one of the estimated 40 million+ Americans who suffer each year from chronic sleep disorders or one of the additional 20 million who experience occasional sleeping problems, you know first hand how the problem can affect your quality of life. A sleep disorder can interfere with all aspects of your everyday activities like work, driving, and participating in social activities. Studies show that there is an established relationship that exists between Obstructive Sleep Apnea (OSA) and TMD. In fact, several studies have shown there to be what is referred to as a high comorbidity between the two disorders and what they discovered was there is a 73% higher chance of having TMD symptoms when two or more signs of OSA are present. Symptoms of TMJ like clenching and grinding of the jaw are highly associated with episodes of obstructive sleep apnea.
All recent studies show that one in six adults and children experience TMD symptoms each year and over 23% of preschool age children have pain when chewing along with jaw joint noises. All jaw joint noises represent a breakdown of the TMJ. Women have also to be shown to be more prone to the condition than men. Young women with low BMI were found to have high rates of multiple sleep disorders and TMD, like bruxism (67%), insomnia (37%) and OSA (23%). Therefore, patients with TMJ symptoms such as primary headaches, jaw pain, chewing pain, ringing in the ears etc., are at a higher risk for sleep breathing disorders and vice-versa.
We have all seen the images of the treatment used to manage sleep apnea that requires sufferers to sleep with a CPAP mask. These sufferers experience obstructed airflow and stop breathing repeatedly during sleep, sometimes for a minute or even longer. This may happen from five times an hour to more than 100 times in severe cases. The body is damaged by only 5 of these episodes occurring an hour and as we learn more, it appears that even minor episodes can cause chronic damage. We know when breathing stops the brain reacts to the situation by producing a rush of adrenalin, which in turn quickens the heartbeat and causes an increase in blood pressure. Muscles in the chest then work to resume airflow and the person gasps for a breath and falls back asleep. This scenario is then repeated multiple times during the same night while the person never realizes what is occurring. That’s because they never really “wake up” but only experience a short pause in sleep. This pause destroys the normal sleep cycle, which is critically important to maintenance of your health and brain function.
People who snore don’t always have sleep apnea, but patients with sleep apnea almost always snore. Snoring represents a partial collapse of the airway. Children who snore should always be checked for sleep apnea since it can impact both the growth of their physical body and proper development of the brain. A lot of children with sleep breathing disorders do poorly in school and tend to be hyperactive. They may also wet the bed, have night sweats, clench and grind in their sleep and tend to have a poor temper. Adults are usually more tired and have other chronic diseases such as high blood pressure, diabetes and strokes.
Sleep apnea treatments
Sleep apnea is usually treated in one of two ways. A CPAP, which is the most common treatment and is considered the gold standard in the medical community, but the problem lies in the statistical usage of this device. Statistically, 50% of all CPAP wearers fail after a year or only wear it for 4 hours a night. The next choice is an oral sleep appliance fitted by a qualified dentist. Sleep apnea is qualified as an episode of not breathing for 10 seconds or longer. People with mild to moderate apnea can choose to start with an oral sleep device rather than a CPAP. Statistics say that 75% of patients who wear oral appliances are still wearing their appliance after a year. There are both pros and cons for each choice, but the bottom line is that the disease needs to be treated. Heart attacks in your sleep are almost always due to undiagnosed sleep apnea. Left untreated, sleep apnea can shorten your life on the average of 7 years, so it is to be taken seriously.