Is There a Connection with TMJ Disorders and Sleep Apnea?

Is There a Connection with TMJ Disorders and Sleep Apnea?

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Hello and welcome to the podcast. I am Dr. Michael Bennett. I am really excited to be with all of you today.

I've had some things on my mind regarding the relationship between sleep breathing disorders and chronic head and neck pain, particularly TMJ disorder.

Now, how many of you out there have suffered from any type, including headaches, of head and neck pain that has lasted more than three weeks? How many of you have had that pain centered in or around your ears, your eyes, your cheeks, under your ears, the back of your head? Any of you out there who have clicking, popping, or maybe even locking of your jaw—those are common, very common symptoms of temporomandibular joint disorder.

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Personal Experiences and Observations

An interesting connection with that happened a long time ago when I was practicing as a general dentist. People would come in with symptoms—headaches, clicking, popping, jaw pain, inability to chew or swallow, or even laugh without pain. Some patients couldn't even kiss their spouse because their jaw hurt so much. I would refer them to TMJ specialists. These wonderful doctors would treat them, but often their symptoms reduced only temporarily. Many had to wear TMJ splints for the rest of their lives. If they removed the splints, their bite would change.

I always wondered—why? Why can’t we completely heal those patients? What’s continuing to aggravate the condition, making it necessary to keep wearing splints indefinitely?

As I reached into the literature more deeply, I found that trauma or injury to the TMJ could be persistent—and not always due to physical accidents. Let’s take a quick look at the anatomy.

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Finding Your TMJ

Use your finger and locate the small bone in front of your ear. Open and close your mouth—you’ll feel a bone roll underneath your fingertip. That’s your TMJ—the head of the condyle of the mandible. It’s a very complex joint. It doesn’t just hinge—it also glides. It’s a ginglymoarthrodial joint. There’s your big word for the day.

The TMJ often acts as a warning light, throwing off symptoms when something’s wrong in the body.

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Exploring the Connection Between Sleep and TMJ

As you heard in the introduction, this podcast is about how to unleash the healing power of sleep. When I considered why patients were not healing from jaw and facial pain, I started looking into sleep. What about sleep could cause delays in symptom resolution—especially headaches, facial tension, and migraines?

I came across a 2013 study published in the Journal of Dental Research titled “Sleep Apnea Symptoms and the Risk of Temporomandibular Disorder.” It validated what I had seen in practice—many of these patients also had underlying breathing problems.

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Demonstration: How Breathing Affects Jaw Position

Let me take you through this briefly. Plug your nose and try to breathe. What happens? Your mouth opens. As your mouth opens, your head tilts back. That’s called forward head posture. Emergency medical technicians use this technique to open your airway when you’re unresponsive—they tilt your head back and thrust the jaw forward.

That means the jaw must move to open the airway. It was a major realization that sleep breathing disorders were contributing to unresolved TMJ symptoms.

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Identifying Sleep Breathing Disorders

In previous podcasts, we’ve talked about signs to look for:

• Tooth imprints on the tongue
• Fissures down the tongue
• Excessively dry tongue
• Crowded teeth or small jaws

All of these increase your risk for obstructive sleep apnea (OSA).

The 2013 study revealed a significant association between OSA symptoms and TMJ disorders. That opened the door to healing—if we screen for sleep disorders, we can finally address the root causes of TMJ dysfunction.

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Chronic Pain and Sleep Disorders

So I hope that's helpful for everybody. That is an important understanding. It's not just a chronic issue like TMJ disorder that is helped when we start sleeping and breathing better. What I'm finding is that people with long-term back pain, shoulder pain, chronic digestive disorders, conditions like irritable bowel syndrome, high blood pressure, metabolic disorders—even diabetes, depression, and anxiety—start improving when sleep gets addressed.

When I have my patients go through a screening process, find out if they have sleep apnea or sleep disorders, and then they get treated, what I find is they start coming back and saying, Hey, I'm starting to get off my medications. I've had patients tell me, I talked with my physician who prescribed it, and they’re saying, “Hey, you're looking really good. Let's tone down the dosage or eliminate it entirely.”

That’s a wonderful thing. Medications are great for the short term, but they always have side effects. Anything synthetic has to be metabolized, and that can be a source of inflammation and toxicity in our bodies. That inflammation can also produce movement disorders like jaw clenching or bruxism.

An interesting side note is that the amount of force our jaw can exert when we clench while sleeping has been measured upwards of 400 pounds per square inch. Just think about that. Take two people and have them stand on a one-inch area of your jawbone—imagine how you’d feel. That’s significant pressure.

As those muscles work that hard and as the teeth come together that powerfully, just think about that jawbone you felt earlier in front of your ear—it’s also being pressed up against your skull bone with that kind of force. No wonder we see clicking, popping, inflammation, and headaches. These are often related to facial jaw and neck pain from muscle fatigue caused by grinding and clenching all night.

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Conclusion and Final Thoughts

Take-home message for you is to remember this: we need to get to the root cause of chronic pain. Chronic pain is the leading cause of why people go to the physician in the first place. They go in and just say, “Doc, I hurt. I need some help.” We all want relief.

If your physician or dentist doesn’t ask you about your sleep, bring it up to them. Ask them, “Could you screen me for a sleep breathing disorder?” Tell them you want to make sure your sleep is working for you and helping your body heal from chronic pain. If they’re not sure how to help, invite them to learn more or consider seeking a second opinion.

In the long term, this approach will help you spend less on healthcare, avoid unnecessary medications, and improve the effectiveness of any treatments you're undergoing—whether they’re for pain, digestion, cardiovascular issues, or mental wellness.

Some people have asked, “Isn’t TMJ disorder just something for crazy people?” They think it's something imagined or psychological—people grinding their teeth from anxiety. But in my experience, the answer is no. That’s a common misunderstanding.

Sure, when someone’s been in pain for a long time, they may develop depression or anxiety. Who doesn’t feel like they’re going crazy after months or years of pain? But many of these individuals probably began with a sleep breathing disorder, a nutritional imbalance, or structural underdevelopment of their airway and jaw. Their mental health issues likely came later, as a result of chronic suffering.

The cycle starts with an underdeveloped airway. That leads to impaired breathing. Poor breathing leads to fragmented sleep. Fragmented sleep creates chronic movement disorders, such as jaw clenching and grinding. Over time, this leads to joint injury, facial pain, muscle fatigue, and even mood instability.

It’s all connected. If we improve the root cause—how well we breathe during sleep—we begin to unravel the whole cascade.

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Actionable Next Steps

For those just joining in, here’s a quick recap:

• Small, crowded mouths often mean small, crowded airways.
• If you have a crowded airway, you likely don’t breathe well during sleep.
• If you don’t breathe well, your body reflexively moves your jaw to open the airway.
• That movement—especially if repeated nightly—injures the jaw, leading to TMJ symptoms and chronic pain.
• Chronic pain can affect not just the jaw but the entire body: neck, shoulders, back, gut, heart, and even mental clarity.

So what can you do?

• Screen for signs of sleep-disordered breathing.
  Look in the mirror: do you have teeth imprints on the side of your tongue? A fissured tongue? Dark circles under the eyes? Do you or a loved one snore, grind your teeth, or wake up tired despite a full night's sleep?
• Talk to your physician or dentist about a sleep assessment.
  They can guide you through the process or refer you to someone who can.
• Watch for signs in your children and grandchildren.
  Clicking jaws, crooked teeth, chronic irritability, or difficulty concentrating may not be behavioral—they might be structural. Early intervention matters.

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Additional Resources

If you want to learn more about the connection between airway health and TMJ pain, visit VivosLife.com for detailed information on biomimetic appliance therapy and airway-centered treatment options.

For professional evaluation and treatment, you can also visit my clinic’s site: Newville Wellness Center in Orem, Utah.

This journey is about unleashing the healing power of sleep—not just for your head and jaw, but for your entire body.

Take care of yourselves, and until next time, breathe deeply and sleep well.

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