We know that sleep disordered breathing like snoring and sleep apnea are strongly associated with TMJ. That’s because the jaw supports the airway, and when the jaw is in an unhealthy position, the airway becomes constricted or may even close.
Now a new study confirms the close relationship between TMJ and sleep quality, showing that deteriorating sleep quality is possibly the strongest warning about the development of TMJ.
Continued Insight from the OPPERA Study
This latest insight comes from the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study. OPPERA, sponsored by the National Institute for Dental and Craniofacial Research (NIDCR) is probably the largest ever study of TMJ. It began in 2006 with the enrollment of about 3200 subjects who were initially free of TMJ. These subjects were given a battery of tests, then observed for years to determine how many of them would develop TMJ–and hopefully why.
OPPERA has produced some surprising insights. For example, it showed that men and women develop TMJ at about the same rates, something that seems impossible because women are five or six times more likely to seek treatment for TMJ. This may mean that there are many men who are suffering from the condition but don’t realize the cause of their chronic pain.
And now OPPERA has made another surprising discovery: poor sleep might be a better warning sign of developing TMJ than many of the traditional risk factors.
As part of the OPPERA study, all subjects were given the Pittsburgh Sleep Quality Index questionnaire. They were then asked about their subjective sleep quality every three months. They found that sleep quality went down sequentially for people who developed TMJ.
To determine how strong the relationship was, researchers compared the 220 people who developed TMJ against 193 controls who didn’t have TMJ. They found that sleep quality decline was associated with a 73% increase in TMJ risk. The association was independent of psychological stress, comorbid conditions, nonpain facial symptoms, and demographic characteristics that might have skewed the relationship.
Why the Connection?
Researchers are somewhat at a loss to explain this relationship. In the past, it was suggested that increases in pain sensitivity might link poor sleep and TMJ. Increased pain might make it harder for a person to sleep, so their quality and quantity of sleep go down because of the pain. But this study showed that increases in pain sensitivity were not associated with sleep problems.
It could very easily be that this is also a warning sign of developing snoring or sleep apnea, both of which can contribute to poor sleep quality. Or possibly there’s another factor here that is yet to be discovered.
But whatever the reason for this relationship, this study reminds us that if you have TMJ, it’s best to get treatment from a dentist who is fully prepared to treat both TMJ and sleep apnea harmoniously, ensuring that both get their appropriate care. If you are looking for a Detroit TMJ dentist who is cross-trained in sleep apnea, please call (248) 825-8277 for an appointment with Dr. Jeffrey S. Haddad at the Michigan Center for TMJ & Sleep Wellness.