Can I Use an Oral Sleep Apnea Device if I Have a TMJ Disorder?

So, can You use an oral sleep apnea device even if you have a TMJ disorder?

Yes. Temporomandibular Joint Disorder does not exclude a patient from the use of an oral appliance. There are some disorders that need to be addressed before the sleep apnea treatment, but in most cases, the TMJ condition is treated at the same time as the Sleep Apnea is being treated.

One of the most widely used FDA and Medicare-approved devices was initially developed for the treatment of TMJ disorders.

For years, I’ve struggled with TMJ disorder, and once I started using a mouth guard and other occlusal appliances, I was able to alleviate the pain and sleep soundly. After doing some research, I was able to conclude why that is the case.

We’ll discuss the benefits of oral sleep apnea devices and which types are best suited for your TMJ disorder.

What is an Oral Sleep Apnea Device and How Does It Help My TMJ Disorder?

A TMJ disorder is when you experience discomfort in your jaw. You may notice a clicking sound or even struggle to open your mouth since the joints feel locked up. On the other hand, sleep apnea is a condition that causes you to stop breathing for short periods while sleeping.

Oral sleep apnea devices look nearly identical to mouth guards. These devices help to treat sleep apnea which occurs when the upper airways are blocked during sleep, causing you to stop breathing.

Many dentists prescribe an oral appliance treatment called Mandibular advancement devices (MAD) to help with sleep apnea related sleep disorders.

MAD’s are devices that are custom-made to fit into a person’s mouth. This oral appliance works by moving the tongue and jaw forward when in use. When the jaw is moved forward, the airway is held open so that you can breathe better. It also holds the tongue to prevent it from falling backward, which would obstruct the airways. Consequently, the device drastically reduces throat restriction and prevents potential sleep apnea.

Many people incorrectly assume that they can’t use oral dental appliances due to their TMJ disorder. Many people have been successful in treating their TMJ disorder and improving their sleep through dental sleep appliances. Your dentist may give you various appliances to try on to test out which is most comfortable for you.

What is the difference between obstructed sleep apnea and central sleep apnea?

Obstructed Sleep Apnea is the most common type of sleep apnea that occurs when the airway gets fully or partially blocked during sleep. This physical blockage reduces the amount of air traveling to the lungs. As air tries to squeeze through the physical blockage, a person snores.

People who suffer from Obstructive Sleep Apnea consistently choke and gasp for air in their sleep when the brain sends signals to wake them up enough to bring back breathing. However, when they fall asleep again, the blockage returns, causing them to experience the cycle numerous times a night. However, not everyone with OSA snores. As such, it’s crucial to pay attention to other symptoms like morning headaches, neck pain and fatigue.

The side effects of OSA include:

• High blood pressure
• Stroke
• Heart disease
• Heart arrhythmias
• Increased risk of diabetes

On the other hand, Central Sleep apnea (CSA) is less common but just as dangerous as OSA. With CSA, the brain doesn’t send signals to wake you up, and as such, the sleep apnea sufferer respiratory effort fails, and they stop breathing temporarily. While those suffering from CSA can wake up several times a night, they often have no memory of the night’s events.

Is TMJ and Sleep Apnea Correlated?

TMJ and obstructive sleep apnea are conditions that might develop together and reinforce one another. One wellness center found that 52% of people with sleep apnea suffer from TMJ, and 75% of people with TMJ suffer from snoring, sleep apnea and other sleep disorders.

Once you experience symptoms of sleep disordered breathing, it can lead to further TMJ damage. Breathing through your mouth causes you to clench your jaw leading to damage in the joints.

Those who struggle with TMJ first usually restrict the airway because the jaw is shifting backward. The physical misalignment of your jaw blocks the airway causing interruptions in breathing.

Although TMJ can go away on its own, dealing with the pain can be incredibly difficult. There are pain-relieving medications and exercises you can do to help improve TMJ. However, the best solution to help with sleep while suffering TMJ is using mouth guards and oral splints.

Types of Oral Sleep Apnea Devices

The best treatment to help with obstructive sleep apnea due to TMJ will vary depending on various factors. This includes your upper airway’s physical structure, the severity of your problem, your personal preference, and any other existing medical problems you have.

CPAP

A CPAP machine compressor generates a continuous stream of air from an air filter into a flexible tube. Then the air travels into a mask that is sealed around your mouth or nose. This device provides positive airway pressure to ensure that you have ample supply of oxygen in your body while you’re sleeping. CPAP machines can be a great alternative to dental devices because they don’t push your jaw forward or affect the position of your jaw, causing facial pain.

You simply place the mask over your mouth while you sleep. But on the downside using this machine may cause difficulty and discomfort in falling asleep, especially in the beginning.

Mandibular Advancement Device

A mandibular advancement device or mandibular advancement splint is designed to fix sleep apnea symptoms, especially those related to TMJ disorder, by gently shifting the jaw forward. This prevents the soft tissues in your throat and mouth from collapsing into the airway.

They look similar to mouth guards used in sports. These contraptions snap over the lower and upper dental arches and have metal hinges to allow your lower jaw to move forward.

Tongue Retaining Device

Tongue retaining devices are used to keep the tongue in the right position so that it doesn’t block the airway. This device is a treatment option, but it is the least tolerated.

Which One is Right for Me?

Typically, you’ll work with a doctor and a dentist experienced in sleep-related breathing disorders to help you decide the best oral sleep apnea device designed for your condition. First, your doctor needs to make sure you are a good candidate for oral appliance therapy, by way of a sleep study. From there, you’ll be directed to a sleep dentist to determine the right appliance after performing a short examination. A dentist will take an impression of your teeth and jaw, send their findings to a lab, and see what is best for you.

Positional therapy for sleep apnea

Positional therapy is a great alternative treatment for patients who cannot or are unwilling to tolerate surgery or CPAP. It works on individuals with positional obstructive sleep apnea. This type of sleep apnea affects 49.5% of people with mild sleep apnea and 19.4% of people with moderate sleep apnea.

Positional sleep apnea therapy helps patients sleep on their side using a special device that wraps around their waist when they sleep. The device has ‘vibrotactile feedback’ technology which vibrates gently when they roll over to their back in their sleep. The vibrations signal your body to roll to the side without necessarily waking you up.

Costs for Sleep Apnea Treatment

The average cost for sleep apnea treatment costs between $2,500 to $3,500. However, your medical insurance often covers these expenses fully or partially. This price includes the dental visits and mouthpieces required, such as adjustments and modifications to the device.

Is it Comfortable?

The level of comfort is unique to the individual. However, most people adapt to using an oral sleep apnea device very well. Eventually, it’ll become a routine, and you won’t want to sleep without it since it makes you feel better.

Many dental appliances are adjustable, allowing you to move your jaw forward gradually without discomfort. It’ll allow you to adjust the device into a comfortable setting. However, you’ll eventually have to speak with a dentist trained in oral health to see if wearing a dental sleep apnea device is right for you.

Although most appliances adjust the jaw, some devices have little effect on your jaw. Some oral sleep apnea devices work by controlling your tongue without having to move your jaw.

Do I Need a Custom Oral Device?

Although there are oral sleep apnea devices that you can purchase through an advertisement on television or any store, a dental appliance that is custom-fitted to your jaw and mouth size will ensure that it is effective and comfortable.

Oral devices that are one-size-fits-all are usually much larger, making the device less effective because it may obstruct your throat’s airway during sleep. Since they’re not adjustable, this leads to pain and discomfort.

When looking for an oral appliance, it’s best to have it custom-fitted and prescribed by a sleep specialist. This ensures that you have proper guidance and medical supervision. Ideally, you want to see a dentist specializing in sleep medicine, and they should also make the device.

How Long Do These Devices Last?

The longevity of these oral appliances will depend on the care of the devices, forces placed on it, how it was made and the person using it. If well maintained, these appliances can easily last between three to five years before a replacement is needed. The most commonly used manufacturers of custom appliances provide a 3 to 5 year warranty. After this time, your medical insurance provider usually will pay for the construction of the new oral sleep apnea device.

Pros and cons of dental appliances for sleep apnea

Many sleep apnea sufferers that order oral devices without consulting a sleep specialist ease their snoring symptoms but don’t prevent apnea events. As a result, they develop complications since the disorder wasn’t treated. Pros and cons of dental devices for sleep apnea include:

Pros

• Most patients feel the dental devices are more tolerable and comfortable than CPAP masks
• Unlike CPAP masks, oral devices aren’t dry and don’t cause itchy noses
• For patients who move a lot in their sleep, there’s less equipment they can get entangled with
• Less equipment is involved

Cons

• Tension, soreness, jaw pain
• Sore gums or teeth
• Dry mouth or excessive salivation
• Possible damage to the bit
• Loosening dental restorations

Will medical insurance cover sleep apnea and TMJ treatment?

It depends. The treatment benefits for TMJ disorders and obstructive sleep apnea that’s medically diagnosed are specified under medical insurance policy and not dental plan. However, medical insurance companies don’t cover snoring treatments alone. If your current medical plan doesn’t cover TMJ treatment, check if it’s covered under dental policy.

Final Thoughts

Unfortunately, TMJ disorder can cause a lot of pain and sleepless nights. However, oral sleep apnea devices can successfully treat TMJ and help supply ample oxygen into your body. Getting more oxygen while you sleep helps improve overall sleep quality, mood and increase stamina throughout the day. Make sure to see your doctor and call Jeremy J. Abbott, DDS to see if a dental appliance is right for you and get custom-fitted for one.