sleep bruxism jaw pain morning headache

Why won’t my TMJ splint help me sleep better? I can’t sleep!

 

  • What is “TMJ”?
  • What is sleep apnea?
  • Is a splint for my top teeth better than a bottom splint?
  • What should I ask my dentist if I don’t sleep well?

The nights that you’re not sleeping and/or waking up feeling amazing may be that your TMJ problem is a symptom and not the true problem. Most patients (and sadly most doctors) see TMJ as the problem and everything else as a symptom of “TMJ disorder”. If you were in an accident and damaged your muscles, nerves, spinal column, etc you may simply have TMJ disorder. TMJ disorder can occur when your muscles are not working properly and are unbalanced. This can cause the muscles of your shoulders, neck, and head to become over worked and stay tight. This “tightness” causes the TMJ symptoms you may be experiencing. A “bad back” certainly can cause this. I have to wear my own TMJ splint every time I cut firewood. Yeah I know. Bend your knees and lift with your legs and not your back. So maybe you’re not sleeping because you have knots also called trigger points in your muscles causing you pain in the middle of the night??? Or maybe that’s not it.

Most if not all of my patients we are treating for sleep apnea also have TMJ disorder symptoms to some degree. Sleep apnea causes fragmented sleep where you are constantly waking and falling back asleep. Each time you wake up for just a split second and roll over and fall back asleep. But after each awakening the sleep apnea causes you to clench and grind your teeth. Sleep apnea can also cause anxiety, depression, trouble focusing at times, sleepiness during the day, and chronic fatigue. So if you have pain in your head, neck, and shoulder muscles plus some of the other symptoms I just listed you true problem may be sleep apnea. And while your TMJ splint may help some it cannot keep your airway open at night. So it cannot help with your sleep apnea. And if you have a TMJ splint for your top teeth and sleep apnea your splint may be making your sleep apnea worse.

Sleep apnea is almost always an obstructive form. This means your tongue is falling back into your throat while you are sleep and cutting off your airway. If it falls back a little you begin to snore. Eventually it falls back far enough to stop all air from entering your lungs. This is sleep apnea. Your tongue is supposed to go to the roof of your mouth when you swallow. If you have a TMJ splint on your top teeth, especially a thick one, this will give your tongue even less room in the roof of your mouth and cause it to move further backwards. Right where it does not need to be! In your throat.

Anyone can have sleep apnea. I have sleep apnea patients that are teenagers, 20’s, 30’s, 40’s, all the way 90. Some of my patients are very thin, some average weight, some obese. One of my sleep apnea patients runs triathlons all over the country. And sleep apnea is not about how you fall asleep. Just because you instantly fall asleep as soon as you head hits the pillow does not mean you’re getting good sleep. Just instant sleep.

If you have a TMJ splint and you’re not sleeping well talk to your dentist about it. At the very least have your dentist make you a splint for your bottom teeth if your splint is for your top. Your dentist may suggest you get a sleep study. These can be taken at home. A sleep study is the only way to tell if you have sleep apnea and how bad it is. If your dentist does not treat sleep apnea you can always find one who does and continue to see your family dentist. No worries there.

Tony Soileau DDS

Tony Soileau DDS

Dr Tony is a general dentist from Lafayette, Louisiana. He was born and raised in Pine Prairie, Louisiana. His practice focuses on restorative, cosmetic, and family dentistry as well as sleep apnea treatments other than a CPAP and TMJ. Dr Tony graduated from LSU School of Dentistry in New Orleans in 1994. He has been president of his local dental society and is an associate professor at LSU School of Dentistry. He has been a faculty member of the Institute of Oral Art and Design (IOAD) in Tampa, Florida and the Pacific Aesthetic Continuum (PAC~Live) in San Francisco. He is a member of the ADDA, LDA, ADA, AGD, AACD, and has his Fellowship in the Academy of Comprehensive Esthetics. He has published over 50 articles on cosmetic dentistry. In addition to being a published author he has and continues to lecture both nationally and internationally on cosmetic dentistry as well as treatment of sleep apnea.

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