Links Between TMJ Problems & Sleep Apnea Coming To Light.

added on: August 15, 2018

When a friend learned that what she was eating was leading to skin rashes, she was puzzled by the connection. Yet, researchers are now connecting the dots between just how closely one system in the body influences the others.

A particular connection that is moving front-&-center is the connection between obstructive sleep apnea (OSA) and TMJ (jaw joint) disorder.

But, how could oxygen intake during sleep be affected by problems associated with the jaw joints?

Results from a number of studies are showing a close relationship between the two disorders. In one study, one-third of participants with TMJ Disorder (TMD) also suffered from obstructive sleep apnea. Through advanced imaging technology, researchers have become better able to hone in on how the connection exists.

In another study, 75 percent of patients who were diagnosed with sleep apnea also reported pain associated with their jaw joints. This has prompted some dentists and physicians to advise their TMD patients to be tested for sleep apnea. For many, an oral appliance that resolves TMD can have dual advantages for sleep apnea sufferers.

Why now? It is felt that the connection hasn’t been obvious before because the “average” patient with each ailment doesn’t share much of a similar make-up.

While age is a risk factor for both genders, sleep apnea tends to be experienced by older men, (who have a 2 to 3 times higher rate of developing the disorder).

Compare this to the average TMD (temporo-mandibular joint disorder) sufferer, who are generally women in the 25 – 50 age range.

Too, the symptoms are very different. While sleep apnea suffers typically snore and are fatigued throughout the day, TMD may cause headaches, ear ringing, or dizziness.

Along with these factors are misdiagnoses that occur. When an individual complains of headaches, many are presumed to be tension headaches. Treatment is often in the form of medications that simply mask the pain, not resolve it.

Even though headaches are a common symptom of TMJ disorder and can occur in sleep apnea sufferers, both conditions are frequently overlooked as the source.

The head is a complex structure of only 10 – 11 pounds. It houses the brain, which is the body’s command center. It also mans sight, hearing, speech, taste, and communication. For all of these functions to occur properly within this small space, proper alignment and balance is vital.

OSA occurs when there are blockages to air intake passages, which can be from a saggy soft palate or a tongue that droops back too far during sleep. It doesn’t take much to cause obstruction to an adequate flow of oxygen. Fortunately, neither does it take much to correct it, in many cases.

In our office, we create small, custom-made oral appliances (mouth pieces) that adjust the position of the lower jaw ever-so-slightly. This small re-positioning can make a significant difference in one’s ability to have adequate oxygen flow throughout the night.

However, for many who suffer with the obstacles associated with sleep apnea, the position of the jaw can also relate to TMJ disorder.

When I see patients who have suffered for years, even decades, with frequent headaches, migraines, dizziness, or ear ringing, my advanced training and experience knows just how slight the disparity can be that causes the problem to occur.

For example, a crown that is one millimeter too high (that’s only 1/25th of an inch) can trigger an alignment disparity that radiates out to the jaw joints. Yet, it’s just enough to set a series of events in motion that can cause severe problems that are seemingly unrelated to bite misalignment.

TMJ Disorder can be caused by an accident or injury that alters the fit of the jaw. This can occur from contact sports, a wreck, or an injury – even those occurring many years prior. (It may take many years for the problems to emerge). However, most problems of the jaw joints stem from bite misalignment.

A Patient having their bite checked

Testing is thorough yet comfortable.

When a bite is misaligned, it can lead to stress and strain on the facial/head muscles and jaw joints. This is especially illustrated through worn teeth, an issue experienced by people who grind their teeth at night.

During sleep, inflamed jaw joints seek out a comfortable position. This can trigger the action of clenching (which has been measured to be forceful enough to crack a walnut) and teeth grinding. Clenching and/or grinding can cause chipped, broken, fractured, or worn teeth.

If you’ve had a crown or veneer come off during something as simple as flossing, it can be because the tooth has been enduring the forces of clenching or grinding. Fractured teeth are also telltale signs.

In addition to the TMD symptoms mentioned above, it can also cause tingling in the fingers. Again, the human body is inter-connected in an intricate way and the repercussions can be far-reaching.

For those who suffer with mild to moderate sleep apnea or TMD (or both!), the problems can be debilitating – and costly. According to the Migraine Research Foundation:

• Healthcare and lost productivity costs associated with migraine are estimated to be as high as $36 billion annually in the U.S.
• In 2015, the medical cost of treating chronic migraine was more than $5.4 billion, however, these sufferers spent over $41 billion on treating their entire range of conditions.
• Healthcare costs are 70% higher for a family with a migraine sufferer than a non-migraine affected family.


For sleep apnea sufferers who drive, AAA Foundation has labeled “drowsy driving” as more dangerous than drunk driving. Falling asleep at the wheel is not uncommon for people who have sleep apnea.

By treating one problem, you may very well resolve the other. And, in many cases, our patients find that treatment is far less involved than they anticipated. Too, treatment can occur without drugs that “zombie” you out, as one patient put it.

Ready to resolve problems associated with jaw joint disorder or sleep apnea? Ready to regain your quality of life and leave the debilitating symptoms of both behind?

The process begins with a consultation appointment. During this time, we’ll discuss your particular symptoms and potential sources that may be contributing factors. I’ll explain our process for diagnosis that is appropriate for your needs and answer your questions.

The consult is free and there is no obligation. Call 586-739-2155 or tap here to begin.




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Dr. Ban R. Barbat

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