A Newbie - Anyone also have TMJ?

txtornado · Post by **txtornado** » Wed Mar 15, 2006 6:28 pm

Hi all. I was just diagnosed today and found this site while looking around for useful info. I'm very early in the process of all this - haven't even officially sat down with my doctor to go over all the details, but am trying to bring myself up to speed as quickly as possible. You guys are a wealth of information!

One question I have is whether there are people here who have TMJ in addition to OSA? I have a pretty severe case of TMJ and sleep with a mouth guard. Anyone else in the same boat? Any thoughts on how/whether the mouth guard affects the CPAP's effectiveness, comfort, etc.?

Thanks for your help!

cflame1 · Post by **cflame1** » Wed Mar 15, 2006 7:02 pm

I'm interested to hear if anybody else answers. I've got TMJ as well and have for years. The sleep apnea... I had my first sleep study last week and I'm still waiting on results.

NightHawkeye · Post by **NightHawkeye** » Wed Mar 15, 2006 7:22 pm

txtornado wrote:One question I have is whether there are people here who have TMJ in addition to OSA? I have a pretty severe case of TMJ and sleep with a mouth guard. Anyone else in the same boat? Any thoughts on how/whether the mouth guard affects the CPAP's effectiveness, comfort, etc.?

Jaw position can definitely affect apnea. Here's a thread about it that I started a month or so ago.
viewtopic.php?t=6954

A few folks mentioned TMJ in it.

As for the mouthguard, I slept with one for a few hours one night, but it made my apnea worse, so I haven't tried it since.

Regards,
Bill

SnoozeHunter · Post by **SnoozeHunter** » Wed Mar 15, 2006 10:48 pm

Yep. I've got it, too. Years ago I wore an appliance 24/7 because my dentist told me I needed one. It was made from a hard plastic or acrylic, fit over my bottom teeth, and worked very well. I don't know what the material was but it was hard and clear. After about a year, I had to get a new crown on one of my teeth and after that the appliance didn't fit anymore.

When I had the new one made, it was of a soft flexible material that fit over my top teeth and was only to be worn at night. According to my dentist, this was better. But it didn't hold my jaw in place, was uncomfortable to wear, and woke me up at night. Since I had never had any symptoms, I stopped wearing it and have never gotten another. That was about 20 years ago.

It's probably coincidence, but last fall when the settings were changed on my bipap, I suddenly started having all those symptoms the dentist had asked (warned) me about years ago. I would wake up in the morning with my jaw askew, or out of alignment. After several hours it would start to feel like it was straight again. It was painful to eat, sharp pains from the tm joint, and a lot of popping in the joint. Sometimes I couldn't get my molars to come together at all. The symptoms lasted about a month and then disappeared and have not reappeared.

Swordz · Post by **Swordz** » Thu Mar 16, 2006 12:51 am

NightHawkeye wrote: Jaw position can definitely affect apnea. Here's a thread about it that I started a month or so ago.

Jaw position definitely affects OSA, as a restricted jaw means restricted airway volume. Over the past year and trips to different types of doctors, it was found my apnea is basically becuase of limited airway space. My mandible is recessed, and that is why the MMA/GA surgery would greatly benefit me.

So yes, jaw position can be a HUGE factor in OSA.

dkeat · Post by **dkeat** » Thu Mar 16, 2006 7:07 am

Be careful of using full face masks if you have TMJ. They can shift your jaw position and exascerbate it. I am unable to use a FF mask for that reason. Had nasty headaches, etc. until I stopped.

Saltydog · Post by **Saltydog** » Thu Mar 16, 2006 7:59 am

I have TMJ. I had not had much of a problem with it for a few years until I went on CPAP about two months ago. I started waking up with a sore jaw while on CPAP. May be due to having a chin strap keeping my mouth closed in combination with the sensory changes I had to adjust to having the equipment on and air forced into my nose-was probably grinding my teeth because of this. I started wearing my dental appliance (upper teeth) and have felt good.

My tongue also seems to remain in the up position, tucked behind the appliance. Which seems to help with restricting air leaks thru the mouth.

Bella · Post by **Bella** » Thu Mar 16, 2006 8:11 am

I think it is the TMJ that causes me problems getting a full face mask to fit. On the other hand, now that I use a Swift, if I put on a chin strap that causes my jaw to shift and hurt like ****. I try to wear my appliance because, if I don't my jaw goes crazy during the day. I was wondering if the Flexi-fit 431(?) that fits under your chin would help provide a stabilizing seal. I don't think, for me that my BiPap has made any difference, other than when I wear the chin strap. But I have CSA, not OSA.

txtornado · Post by **txtornado** » Thu Mar 16, 2006 9:58 am

Thanks for the responses.

I got my TMJ mouthguard back in June and wear it every night. It's hard plastic that fits over my top teeth. Before getting that, I would wake up with excrutiating jaw pain and headaches that lasted all day. That has stopped since wearing the guard.

It seemed that just as my TMJ was getting under control and jaw pain was no longer ruining my sleep, something else kicked in, which led to my doctor ordering a sleep study and now a diagnosis of OSA.

I have to admit that I'm a little nervous about wearing both my mouthguard and a mask/nasal pillows every night as I'm a bit claustrophobic and that seems like a lot of "stuff" to be in or on my face at once. But I'm sure it will all work out.

k.c.snorzalot · Post by **k.c.snorzalot** » Thu Mar 16, 2006 12:08 pm

If you are not a mouth breather, try to stay away from anything with a chin strap. If you have a recessed bottom jaw, the chinstrap pressure will make your TMJ much worse, it did mine, so I nixed the chinstrap.

elliejose · Post by **elliejose** » Thu Mar 16, 2006 10:00 pm

I have severe TMJ. Have had it since a child. When in grade school, I would often have my jaws lock. Most nights I wear my appliance. Mine is hard plastic or whatever it is on the upper teeth with a part that protrudes down to pull the lower jaw forward. And even tho it pulls my lower jaw forward, I cannot tell a difference in AHI with it or without it.
MD finally decided that the discs in my jaws had disintegrated and that short of surgery, there was not much help for me. At that time his opinion was the same as mine (thank goodness). He suggested no surgery until the pain became unbearable. Said that often, people are allergic to the material the discs are made of or other problems develop and they have more problems after the surgery than before.

Bella · Post by **Bella** » Fri Mar 17, 2006 6:48 am

elliejose, I'm almost the same as you. The right side of my jaw is shot. The left side is getting there now. My appliance sounds to be the same as yours too. When I got it the dentist said that I could wear it during the day. Ha! No one would understand me.

k.c.snorzalot: I've decided to give up on wearing a chin strap. I'm waking up at night and taking it off. Last night I tried both, and it lasted for about 4 hours. Now this morning, my left jaw is killing me. When I first went on BiPap, I got a full face mask because I couldn't believe that I did not breathe through mouth. When the noise of the ff mask drove me crazy, I switched to a Swift, but got the chin strap for the same reason. I think now, that I do not breathe through my mouth, but I have still been trying out the chin strap now and again. I think last night is the last night. My lower jaw is short, and between the compression of the chin strap, me clenching my teeth, and pulling back on that protruding part of the appliance, it hurts and disrupts my sleep.

kikisue · Post by **kikisue** » Fri Mar 17, 2006 10:28 am

I have TMJ and wear the appliance on my upper teeth. When I first started CPAP, I was using the Breeze nasal pillows and mouth breathing. I found I CANNOT use a chinstrap - woke up after just a few hours in serious pain. Went the taping route for awhile - but now I'm using the Ultra Mirage FF mask and it's working well for me. It took awhile to figure out the "sweet spot" for leaks, but it's working now. I haven't had any issues with using it and my night guard - no jaw pain or headaches.

As to how it all works together - getting used to the night guard when I first got it took awhile, but I adjusted. Then, went on CPAP and thought I'd never get adjusted - but I did after a couple months of trial and error. Now, it's all just simple as pie - wash my face, put in the night guard, climb in bed, put on the mask, hit the on button, and off to sleep I go! I'm actually falling asleep far faster and staying asleep all night - no more night-time runs to the bathroom. What a difference! So, just to encourage you - it may seem tough at first, but you will get used to it over time.

As to the chinstrap - I've found a new use for it. I use it over my FF mask, to steady it and stop the leaks. For some folks, it would seem too many straps - but I find the peace I get from leaks far offsets any discomfort from more straps over my head. Your mileage may vary, of course.

Hang in there, and good luck with your therapy!
Karen

Guest · Post by **Guest** » Fri Mar 17, 2006 3:36 pm

Karen,

Thanks so much for your post! It was very reassuring. I'm itching to sit down with my doctor and go over the results (next Thursday morning) so I can get started on treatment. As nervous as I am about the whole process (not to mention the cost, since my insurance covers ZERO ) I am looking forward to not being a zombie all the time.

Val

txtornado · Post by **txtornado** » Fri Mar 17, 2006 3:37 pm

whoops - that Guest response to kikisue was me - I forgot to log in.

A Newbie - Anyone also have TMJ?

A Newbie - Anyone also have TMJ?

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