TMD and Sleep: The Connection

By Jeffrey L. Brown, DDS

Sleep & TMJ Therapy

. http://sleepandtmjtherapy.com/

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TMD and Sleep: The Connection

It may be hard to believe, but when you have a TMJ disorder (otherwise called TMD), this can correlate to sleep-disordered breathing (SDB). The way this works is that when the jaw joint discs are displaced – just like a kneecap can slip out of place – you get pain. Pain and inflammation are quite common with a displaced jaw disc. When you are hurting, you just cannot sleep all that well. Also, the quality of sleep is compromised because it is now harder to get the good, deep, non-REM sleep that helps our body to heal.

It is unfortunate that TMD is so poorly understood because so many people really do need help in this area. It is actually fairly easy to get a handle on this disorder, however. One of the first signs of TMD is that you have clicking and/or popping in the jaw joints. This is often a clear sign that the articular discs (jaw joint discs) are displaced and causing an inflammatory reaction.

Another very clear sign of TMD is that you cannot open your jaw widely. The “normal” range of motion is generally considered to be around 50 mm. This means measuring from the tip of the upper front teeth to the tip of the lower front teeth when opening wide, you should get around 50 mm. Some practitioners say that 35mm is around normal, but in general most agree that 50mm is a healthier way to be. This measurement can readily be done when you see your dentist or hygienist but most of the time it is not done.

So, now let’s get back to the link to sleep problems. If and when the articular discs in the jaw joints are displaced, they are going to rub around in the jaw sockets and will quite literally pinch or rub against nerves and blood vessels in the joint. Diagnosis: It just plain hurts. In the human body when a bone rubs against bone or other vessels, it just hurts, simple as that. This in turn begins an inflammatory reaction in which the body releases the mediators of inflammation called “cytokines”. Now these cytokines are floating around inside your body causing a chronic irritation. It’s kind of like being chronically sick all the time.

When the body is running in inflammation mode, it hurts, and this leads to sleep difficulties. What happens in so many people are the jaw joints ache, which in turn leads to the neck being irritated, and then it travels down the back as well. This makes the deep sleep – called non-REM III – unable to happen the way it should. Now you are sleep deprived and not able to heal the body like your body intended. This cycle just gets worse and worse over time. In so many people, this will lead to OSA – obstructive sleep apnea. So be safe, be smart, learn about TMD and how to treat it for a good night sleep.