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The Connection Between Sleep Apnea and TMJ - Dr. Donald R. Tanenbaum DDS MPH

The Connection Between Sleep Apnea and TMJ

Author: Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain

Date: April 24, 2018

Medical research continues to assess how poor sleep quality and sleep disorders in general influence pain thresholds and the experience of muscle and joint pain. One common area of study pertains to obstructive sleep apnea and the larger field of sleep-related breathing disorders – conditions that can lead to fragmented sleep.

Therefore, if you have TMJ pain, it’s really important to tell your doctor if you have a sleep-related breathing disorder (including sleep apnea), and here’s why.

The Connection Between Sleep Apnea & TMJ

According to the Mayo Clinic, sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. You may have sleep apnea if you snore loudly, and you feel tired even after a full night’s sleep. [ The most common type of sleep apnea is called obstructive sleep apnea and occurs when your throat muscles relax and cause pauses in breathing. Each pause in breathing can last from a few seconds to several minutes and can occur up to hundreds of times per hour.

This fragmented sleep can have a detrimental impact on your overall health. Aside from the obvious impact of not getting enough sleep that can include irritability, trouble concentrating, and being sleepy during the day, sleep apnea can trigger headaches, migraines, heart problems, and increase your sensitivity to pain. There are a myriad of reasons that people develop sleep apnea. Obesity, a narrow airway, large tonsils, sedatives, and smoking or drinking alcohol before bed are just some of the risk factors.

The bottom line is this. When something restricts normal breathing, oxygen levels will drop. When your oxygen levels drop, your brain will become stressed. And a stressed brain opens up the possibility of many other problems, including sleep bruxism, which is when you grind and clench your teeth while you’re sleeping. Bruxism can cause your jaw joints (TMJs) to be overworked leading to all kinds of problems, including pain.

Sleep Apnea Can Lead To Bruxism

A number of years ago, TMJ doctors began to notice that a large percentage of their patients had the signs and symptoms of sleep apnea. Studies revealed that breathing restrictions, like those accompanying sleep apnea, can trigger the nightly occurrence of sleep bruxism.

The Role Of Pain – A Double-Edged Sword

If you’ve ever been in chronic pain you know that getting a good night’s sleep can be quite a challenge. Moreover, studies reveal that insufficient sleep can actually lower your threshold of pain, meaning you feel pain more intensely than if you were well-rested. The reason is this: when you don’t sleep well your body can’t produce a normal level of endorphins (the “feel-good” chemicals that promote a sense of well-being).  On top of that, poor sleep can cause your nerve pathways to malfunction – which causes a more intense experience of pain.

So, it can go both ways.

When breathing difficulties disrupt your sleep, you become more at risk of developing bruxism. And if your overworked jaw muscles become painful, the pain can cause fragmented sleep. It’s a symbiotic relationship.

Hopefully, you can now see the connection between sleep apnea and TMJ. Please consider getting evaluated for sleep apnea if you’re suffering from TMJ pain. A careful evaluation process, which may include an overnight sleep study (which can now be done at home!) will determine the best type of treatment.


As the associations between jaw pain, sleep disruption and sleep bruxism continue to unfold, the need to be evaluated by a well-rounded team of medical professionals becomes even more important. The ability to have sleep testing done at home and the more recent emergence of telemedicine consults to assist patients in obtaining preliminary sleep consultations, improve doctors’ ability to arrive at accurate diagnoses. This in turn will lead to more effective treatment.

If you’re suffering from TMJ-related pain and have tried everything, it’s time to see a specialist in orofacial pain. If you live in the NYC metro area, I invite you to make an appointment for a consultation at my Manhattan or Long Island office. If you are outside of New York, go to this website and search for a Diplomate in your area.

Note: BOTOX®, which has been frequently been mentioned in the news, can at times be a helpful treatment once the assessment process has been completed. You can read about the experience of one of my patients and how BOTOX® helped her here.

DISCLAIMER: The advice offered in response to your questions is intended to be informational only and generic in nature. Namely, we in no way offer a definitive diagnosis or specific treatment recommendation for your particular situation. Our intent is solely educational and our responses to your actual questions serve as a springboard to discussion of a variety of dental topics that come up in a day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified professional.

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