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Do TMJ Splints Worsen Sleep Apnea?

TMJ sufferer with a Tension HeadachePeople with TMJ (temporomandibular joint disorder) suffer from numerous symptoms that can affect their daily lives, including headaches, facial pain, jaw pain, and sore muscles in the neck and upper back. The chronic pain they experience may drive them to take pain relief medication on a regular basis, which puts them at risk for liver or kidney damage, as well as possible overdose.

The use of a TMJ splint is a completely reversible, noninvasive treatment for this condition, which makes it a good one for many sufferers of this condition. However, sleep apnea is a potentially lethal condition, increasing a person’s risk for heart disease, mental problems, and serious injury accidents when driving or at work. If the TMJ splint leads to sleep apnea, it may not be a recommended treatment for people with this condition.

Understanding the Connection between TMJ and Sleep Apnea

There is some suspicion that sleep apnea may be a causal factor behind TMJ. In a recent study, people with sleep apnea were shown to be at an increased risk to develop TMJ. However, we are not sure whether there is a causal link between the two. This means that:

  • Sleep apnea may cause TMJ
  • Sleep apnea and TMJ stem from the same cause

Sleep apnea may contribute to TMJ in the same way it contributes to other joint problems, such as rheumatoid arthritis. However, sleep apnea and TMJ may be due to similar problems of jaw configuration. When the jaw isn’t in a proper position for holding the airway open at night, it may also not be in a good position for maintaining balanced bite forces.

Should Sleep Apnea Sufferers Avoid TMJ Splints?

There is some evidence that TMJ splints can make sleep apnea worse, mostly from two studies. The first, published in 2004, looked at 10 patients with sleep apnea. These patients experienced elevated respiratory disturbance index (RDI) and snored more when they wore their appliance. The effect on a person’s apnea-hypopnea index (AHI) was not statistically significant.

The second study was published in 2013, and it showed an effect on the AHI, but a very small one. Patients wearing a TMJ splint had an AHI of 17.4, compared to an AHI of 15.9 without the splint. When looking at the 95% confidence interval, however, it’s clear the effect isn’t quite significant. The confidence interval ranges from -1.9 to 4.7, which means that they aren’t sure whether TMJ appliances really increase AHI or not.

According to neuromuscular dentist Dr. Adam Hahn of Smile Columbia Dentistry in Columbia, SC, “The effects we’re talking about here are small, if they are even real. People should not be afraid of a TMJ appliance because they suspect sleep apnea. Instead, they should talk to their doctor and dentist about both conditions in order to determine the best treatment option.”

When looking for a dentist to treat TMJ, people are encouraged to work with a doctor who treats both TMJ and sleep apnea, so that the dentist can weigh the risk factors of both conditions and design an optimal treatment plan.

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Thanks to Dr. Adam Hahn of Smile Columbia Dentistry in Columbia, SC for his contribution to this article.

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