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Sleeping Soundly: How Sleep Studies Can Help Diagnose TMJ Disorders

Jun 20, 2023

Sleep is one of the most important components of a healthy life. Without enough of it, your body can struggle to stay energized and alert, your mind can become foggy and confused, and you may have difficulty concentrating or remembering things. 


Sleep disorders are among the most common culprits of poor sleep, and many people may not even know they’re suffering from one. Sleep disorders can develop for a number of reasons, including as a result of irregularities in the temporomandibular joint, or TMJ. Disorders of the TMJ, or TMD, have been linked to everything from chronic fatigue to sleep apnea. TMDs can develop alongside these and other conditions or even reinforce them, creating a painful cycle of sleeplessness.


Dr. Katherine S. Phillips of Restore TMJ & Sleep Therapy is board-certified in both dental sleep medicine and orofacial pain, and for more than a decade, she has committed her practice to treating patients who suffer from sleep and TMJ disorders. Not only can she help determine if you or a loved one is suffering from TMD or other sleep disorders, but she can help develop and direct effective and personalized treatment for optimal results, so you can sleep better and live healthier. 


What is a sleep study, and would you need one?

Sleep studies are conducted to diagnose and assess the severity of sleep disorders, including those associated with TMD. They may also be conducted to determine the best course of treatment for a sleep disorder.


If you have difficulty sleeping or experience pain in your jaw, head, or neck when you wake, you may be suffering from a TMD that is interfering with your ability to get a good night’s sleep and impacting your overall health and well-being.


A sleep study can also help diagnose other disorders which prevent you from getting a good night’s sleep, such as sleep apnea or restless leg syndrome. Your doctor may order a sleep study if you are frequently sleepy during the day, snore too much, have trouble falling or staying asleep, or have unusual behaviors during sleep.


During a sleep study, patients are monitored overnight in a sleep laboratory by trained specialists. The specialists will monitor the patient’s brain waves, eye movements, muscle activity, heart rate, and breathing during sleep. This allows them to determine if a person has a sleep disorder and how severe it is.


The Connection Between TMJ Disorders and Sleep Apnea

Both TMD and sleep apnea can affect your sleep, and the two are often connected; nearly three-quarters of people with TMJ also suffer from sleep breathing disorders, while over half of sleep apnea sufferers also experience problems with their TMJ, although it is difficult to say if one is more likely to cause the other.


Pauses in breathing during sleep are a primary symptom of sleep apnea. These pauses can last for several seconds to minutes and occur dozens of times per hour.


TMJ disorders may have various causes, including bruxism (clenching or grinding your teeth), mood disorders, musculo-skeletal conditions, and medication, to name a few.

Conversely, poorly aligned teeth or jaws from a TMD can cause your airway to collapse and obstruct your breathing, leading to sleep apnea.


An Overview of Different Types of Sleep Studies

Different types of sleep studies are available to help diagnose sleep apnea, TMD, and other sleep disorders. Here is an overview of the most common types.


Home Sleep Apnea Test

A home sleep test is done at home to measure your breathing during sleep. It is similar to an in-lab sleep study but is less invasive and can be done in the comfort of your own bed.

The home sleep apnea test may include different types of monitors and sensors. You’ll attach some around your chest and abdomen with straps. They measure your heart rate, breathing patterns, and blood oxygen levels. Other sensors are clipped to your finger or worn around your wrist. They track your heart rate and movement overnight. 


The results of a home sleep apnea test are usually available within a few days. Your doctor will review the results and make recommendations for treatment.


Pros: Easy; cost-effective; done in the comfort of your own bed

Cons: Only measures disordered breathing; less accurate in identifying specific disorders

Best For: Patients with suspected sleep apnea


In-Lab Polysomnography (PSG)

An in-lab PSG is done in a hospital or sleep center and is used to assess your sleep patterns and identify any sleep disorders you may have. During an in-lab PSG, sensors are placed on your head and body to measure your brain activity, eye movement, muscle activity, heart rate, and breathing during sleep.


The technician will begin by attaching various sensors to your head and body. This includes electrodes on your scalp, chin, chest, and legs. They may also attach finger clips or a nasal cannula to measure oxygen levels in your blood. Once the sensors are attached, you will be connected to an EEG machine that records your brain activity while you sleep.

Once the test is complete, the technician will remove all of the sensors. The results are then analyzed by a qualified sleep specialist who can make the appropriate diagnosis and suggest treatment options if necessary.


Pros: Thorough and accurate; used to diagnose a variety of sleep disorders

Cons: Cost; long wait times for scheduling; sleeping in a lab on their schedule

Best For: Patients who may have more complex sleep issues


Split Night Study

Another type of sleep study is called a split-night study. This study is done in a sleep laboratory for one night and accelerates the diagnosis and treatment phases for patients who are suspected of having obstructive sleep apnea. The first part is the diagnostic test to find out if apnea is present and how severe it is. After sensors are placed on your head and body, you will be monitored for about four hours to see how well you sleep.


During the second part, you’ll be fitted with a mask connected to a CPAP (continuous positive air pressure) machine. Your sleep and breathing will continue to be monitored and the air pressure adjusted as needed until the correct pressure setting is found to keep your airway open during sleep.


Pros:  One night versus two for reduced time to treatment

Cons:  Shortened windows to collect data; missed REM sleep data

Best For: Patients with severe sleep apnea or those who cannot return for a second night


Maintenance of Wakefulness Test (MWT)

The MWT is a type of sleep study that is used to assess your ability to stay awake at four separate times during the day. During the test, you will be asked to sit in a dark, quiet room and try to stay awake for as long as you can. The test is typically done in a sleep clinic in the morning and afternoon.


During the test, you will be monitored by an electroencephalogram (EEG) machine to measure your brain waves and determine whether you are awake, drowsy, or asleep. If you fall asleep, you will be woken up after 90 seconds, and there will be a two-hour break before the next testing session. 


At the end of the test, your results will be assessed, and you may be given a score on how well you stayed awake during the test. This score can help provide doctors with information about your level of alertness and help them make decisions regarding treatment options for narcolepsy or other related disorders.


Pros: Can assess the effectiveness of a treatment plan 

Cons: Not diagnostic; takes much of the day 

Best For: Patients who have trouble staying awake during the day


Multiple Sleep Latency Test (MSLT)

An MSLT is a type of sleep study that is often used to diagnose narcolepsy. During an MSLT, you will be asked to take several short naps throughout the day. The test measures how quickly you fall asleep during these naps, how long you stay asleep, and whether you have REM sleep during the nap. 


Your doctor will take into account the amount of time it takes for you to fall asleep and how long you stay asleep when interpreting the results. These results can help to diagnose narcolepsy or other sleep disorders. This test is usually done in conjunction with a polysomnogram, which measures different brainwaves and body functions during sleep.


The results of the test can help your doctor determine whether or not you have narcolepsy. They are also used to assess the effectiveness of treatments for insomnia.


Pros: Used to diagnose narcolepsy and idiopathic hypersomnia 

Cons: Takes much of the day 

Best For: Diagnosing causes or conditions associated with excessive daytime sleepiness


Why should I start with a TMJ specialist for my sleep study?

There are many reasons to start with a TMJ specialist if you are struggling with your sleep, such as:

  • A large majority of patients with TMJ conditions also suffer from sleep disorders like sleep apnea. TMJ specialists have a unique understanding of the connection between the TMJ, dental health, and sleep, allowing them to properly treat both TMD and sleep disorders, instead of only one or the other. TMJ specialists are trained to identify commonly interrelated problems between the TMJ and sleep disorders so they can treat the condition, not just the symptoms.
  • A TMJ specialist who is experienced in dental sleep medicine, like Dr. Katherine S. Phillips of REstore TMJ & Sleep Therapy, can address and treat a variety of dental-related sleep problems and disorders such as bruxism, TMD, snoring, and sleep apnea. TMJ specialists have access to a range of comprehensive treatment methods like oral appliances, therapy, and stress management, as well as established relationships with other medical experts like dentists or sleep physicians, to provide the best, most complete care possible. “There is a direct relationship between sleep-disordered breathing and TMD,” says Dr. Phillips. “Working in dental sleep medicine allows me to work in a collaborative environment to provide the best patient-centered care possible.”
  • A TMJ specialist can also provide you with information about lifestyle changes that may help relieve your TMD, bruxism, or sleep apnea symptoms, such as avoiding hard and chewy foods, maintaining good posture, and practicing stress-relieving techniques such as relaxation exercises or meditation. 
  • TMJ specialists are very familiar with sleep studies. Not only can they help you determine which one is right for you, they can refer you to the necessary facilities and then accurately interpret the findings to make sure you receive the most appropriate treatment for long-term results.


Trust REstore TMJ & Sleep Therapy for Your Best Sleep

Dr. Katherine S. Phillips of Restore TMJ & Sleep Therapy is double-board-certified in Dental Sleep Medicine and Orofacial Pain, combining her experience and education with an established network of trusted healthcare providers to develop and direct the personalized sleep treatment you need for better sleep and better health. She’s helped thousands of patients with TMD, bruxism, and sleep apnea live happier lives free from orofacial pain, and she’s dedicated her career to helping people preserve their oral health.

If you think TMJ pain, bruxism, sleep apnea, or some other sleep disorder may be affecting the quality of your sleep or that of your loved ones, contact REstore TMJ & Sleep Therapy today to schedule a sleep study.

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Dr. Kathrine Phillips
About The Author
Dr. Katherine Phillips, DDS, MS received her undergraduate degree from the University of Michigan and her dental degree from the University of Detroit Mercy School of Dentistry. She currently serves as the Secretary/Treasurer on the American Board of Dental Sleep Medicine (ABDSM) Board of Directors and treats TMD and sleep disordered breathing at Restore TMJ & Sleep Therapy in the Houston, TX area. 
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Teeth grinding is the most common cause of jaw pain. Grinding your teeth also results in fractured teeth and the destruction of dental work, which can even change how you look. People who grind their teeth during the day can make conscious changes to reduce their teeth grinding for those who grind their teeth at night . Fortunately, with a visit to Dr. Phillips, you can discover how to stop grinding your teeth. What is Teeth Grinding, and What Causes it? Grinding or clenching your teeth, or bruxism , is a common condition affecting millions of people and, if left untreated, can lead to broader health issues. According to the American Dental Association (ADA), a 2020 ADA Health Policy Institute report stated that half of the dentists saw a rise in clients with stress-related dental problems, primarily due to teeth grinding and jaw clenching. It can happen during the day or night and often goes unnoticed until the person is alerted by a partner or family member. Treating bruxism can prevent further damage to the teeth and relieve any symptoms associated with the condition, and there are several steps you can take to stop grinding your teeth and protect your oral health. People grind and clench their teeth for various reasons, including stress and anxiety, misalignment of the teeth and jaw, or an abnormal bite. In adults, teeth grinding is often caused by emotional tension and stress and can become a subconscious habit. In children, teeth grinding is usually due to an immature bite and can be triggered by new teeth erupting or the recent placement of braces. How Do You Know if You're Grinding or Clenching Your Teeth? Grinding or clenching your teeth can be challenging to identify since it usually happens when you are unconscious or sleeping. However, several signs could indicate you are grinding your teeth. Common symptoms of teeth grinding include: Waking up with a sore jaw Frequent headaches Increased sensitivity or pain in your teeth Tired or tight jaw muscles Pain that feels like an earache, but there is nothing wrong with your ear A locked jaw that is difficult to open or close completely Neck or face pain Noticing that your teeth feel different or worn down You or your sleep partner may also notice that you make clenching or grinding sounds during the night. At a dental appointment, your dentist may suspect teeth grinding if you have the following: Teeth that are chipped, loose, flattened, or fractured Worn enamel on your teeth Gum recession Possible Causes of Teeth Grinding Many people grind their teeth and tighten their jaws without realizing it, especially at night. Although stress and anxiety can lead to teeth grinding, other common causes are: Posture. Poor posture is not only horrible for your back; it's also bad for your teeth. When the body's joints aren't in proper alignment, it can result in jaw clenching and grinding. Misaligned teeth. If the upper and lower teeth don't fit together correctly, the misalignment may result in the tendency to grind teeth or clench jaw muscles. Sleep disorders. Sleep habits and sleep disorders can lead to teeth grinding at night. Chronic obstructive sleep disorder , also known as sleep apnea , is a known cause of sleep bruxism. Resolving sleep apnea can help stop teeth grinding. Sleep terrors and insomnia may also result in grinding teeth at night. Joint disorders. The temporomandibular region is around the jaw, mouth, and ears. This area contains the temporomandibular joints and jaw muscles, which allow the jaw to open and close. Disorders in this area can affect teeth grinding and a sore jaw. Stimulants. Stimulants like caffeine, nicotine, and alcohol can trigger teeth grinding. Avoiding these can help prevent teeth grinding. Stress. Stress is a common cause of teeth grinding and clenching. Finding ways to manage and reduce stress can help decrease teeth grinding. These can include relaxation techniques such as progressive muscle relaxation, yoga, deep breathing, meditation, and guided imagery can help relax the jaw muscles and stop teeth grinding. Chewing on Objects. Chewing on objects such as pencils or fingernails can trigger teeth grinding. You may also need to avoid chewing gum, which can exacerbate teeth grinding. Finding out how to stop grinding teeth at night takes getting to the root cause of grinding. Discovering the cause provides clues, pointing to the appropriate solutions. Prevent teeth grinding during the day. It is crucial to identify triggers that cause teeth grinding if you intend to stop grinding them during the day. Pay attention to your habits during the day and see if you notice when and if your grinding or clenching is worse. A TMJ specialist or dentist specializing in bruxism can provide you with exercises or relaxation techniques you can do throughout the day if you notice yourself clenching and, in some cases, offer medical treatment like muscle relaxants or Botox for bruxism. Prevent teeth grinding and clenching at night/in your sleep. You'll have to make changes during the day to stop grinding or clenching your teeth at night or in your sleep. Start by talking to your dentist or doctor to determine if you have underlying medical issues that could be causing the grinding. Additionally, your dentist may suggest you wear a mouthguard, splint, or other oral appliance. At the same time, you sleep to protect your teeth from further damage and keep your mouth in the proper alignment, helping your TMJ to relax. A custom-fitted mouthguard also helps lessen the impact of teeth grinding by covering the teeth to create a physical barrier that reduces damage. How To Stop Child/Baby Grinding Teeth Many children grind their teeth at night, but most grow out of it. If your child or baby grinds their teeth, the first thing to do is identify what might be causing the behavior. Stress, anxiety, or an underlying medical condition can cause your child to grind their teeth. If the grinding is stress-related, identifying and addressing the source of the stress, such as an overly demanding school schedule or peer pressure, may help. If a medical or dental condition causes the grinding, your child's dentist or doctor can help you determine the best action. If the grinding results from a habit, it can help redirect your child's attention when they start to grind and provide them with other activities that may help reduce their stress and anxiety. Side Effects of Teeth Grinding Grinding your teeth may seem like a harmless habit. After all, it's easier to notice this behavior if you're not on the lookout for it. And unless your significant other or family members complain about the noise from your nighttime teeth grinding, it's difficult to find proof of the act. However, long-term grinding of teeth at night can lead to significant side effects like: Pain in the jaw. The pressure and movement from teeth can lead to tenderness in the muscles, causing jaw pain . For some people, the pain may become chronic and severe. Headaches. The constant back-and-forth movement and clenching can impact the muscles around the neck and head, resulting in headaches due to muscle fatigue and tension. Wearing down teeth. Like sandpaper eventually smooths a surface, the repetitive motion from teeth grinding can flatten teeth and wear the enamel down over time. Teeth grinding can change the appearance of your teeth, causing them to look shorter and making chewing more difficult. Damage or fractured teeth. Grinding can destabilize teeth, making them shift and feel wobbly. The force from grinding may also crack teeth, causing pain and affecting oral health. Misalignment and cracked teeth can result in gum disease, cavities, and tooth loss — leading to poor overall health. Chronic ear pain. The temporomandibular area is closely connected. If the muscles around the ear become affected due to teeth grinding, chronic ear pain may occur. Facial muscle changes. Most people need to be aware that teeth grinding can change the shape of your face. Long-term bruxism can cause shorter teeth. Shorter teeth, in turn, change the structure of the face and jaw — leading to a sunken appearance. In addition, other muscles around the face can enlarge to compensate for dental changes. If you're concerned about your appearance, you may want to note that chronic teeth grinding can change the way you look. Remedies for Teeth Grinding The methods for how to stop teeth grinding at night versus teeth grinding when you are awake are typically the same. Although some treatments aren't quite possible when you're asleep, their benefits can last even after you've gone to bed. Reductive coronoplasty. Reductive coronoplasty directly involves changing or leveling the biting surface of teeth. This procedure reshapes crowded or crooked teeth, improving teeth alignment. Conversely, additive coronoplasty can add to the surface of teeth to help treat bruxism. Dental Appliances: Mouthguards, night guards, and splints. A mouthguard does just that — it guards teeth. Typically used for sports, a mouth guard keeps teeth from injuries sustained during activity. A night guard protects teeth from grinding at night. Lastly, a bit splint guides jaw movement, enabling the jaw to land in the appropriate position. These appliances protect teeth differently, and finding the right one for your situation is essential. Biofeedback. Biofeedback allows a person to train themselves by monitoring auditory and visual stimuli from the body. Although biofeedback needs a person to be alert, the technique can still help sleep bruxism by reducing overall stress. Stress reduction techniques. Though implementing stress reduction techniques such as yoga, exercise, and meditation requires a person to be awake, they can also help with nighttime teeth grinding. Allowing muscles to decompress and relieve tension alleviates stress-induced teeth grinding, even at night. Tongue and jaw muscle exercises. Most people don't stop to think about it, but their faces and mouth are a team of tissue, muscles, bones, and joints that closely affect each other. The tongue, for example, affects how the jaw moves. You reduce teeth grinding by exercising the right muscles — like the tongue and jaw. Behavior changes. Behavioral modifications like changing your posture and avoiding environments that cause stress can reduce instances of teeth grinding. Cognitive Behavioral Therapy (CBT) can help change behavior and thought patterns that lead to teeth grinding. Medications. A doctor can prescribe medication to help treat bruxism if all other treatments don't work. When used for short periods, muscle relaxants can relieve tension in the temporomandibular area. In severe cases of teeth grinding, botox injections can alleviate muscle tension. Antidepressants and anti-anxiety medications assist in decreasing anxiety, allowing jaw muscles to relax and reduce bruxism. How Can a TMJ Specialist Help with Teeth Grinding and Clenching? A TMJ specialist is a dentist board-certified in orofacial pain and conditions affecting the TMJ. TMJ specialists have extensive knowledge and experience regarding the structure, function, and pathology of TMJ. In addition to more thorough diagnostic evaluations, they can often provide more effective and long-term solutions for teeth grinding than your doctor or dentist alone. This is because TMJ specialists use a holistic approach to treatment, focusing on the underlying causes of the teeth grinding, such as stress, anxiety, or misaligned teeth, rather than just treating the symptoms. They often work with other medical experts like dentists or sleep physicians for more comprehensive care and treatment. Protecting Your Oral Health Protecting your teeth is critical to taking care of your overall health. Chronic teeth grinding can result in costly dental work, poor oral health, and chronic pain. If you're experiencing a sore jaw, headaches, or cracked teeth, seeking an expert diagnosis to find the cause is the first step to finding a solution. Get the answers you need on how to stop grinding your teeth at night or keep from grinding in the daytime to protect your oral health. As a TMJ and sleep apnea dentist, Dr. Katherine Phillips specializes in diagnosing and treating bruxism. With her Master of Science in Orofacial Pain From USC and extensive experience in TMJ therapy, Dr. Phillips utilizes proven and effective evidence-based medical interventions to identify bruxism and help find the right treatments to suit your needs. Get in touch today for more information.
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