The aim of the study – published earlier this month in the Journal of Dental Research – was to test for an association between obstructive sleep apnea (OSA) and TMD. Analyzing data from a large, ongoing study of orofacial pain (OPPERA, or Orofacial Pain: Prospective Evaluation and Risk Assessment Study), the authors found that “a significant association of OSA symptoms and TMD, with prospective cohort evidence finding that OSA symptoms preceded first-onset TMD.”
In other words, yes, OSA and TMD often occur together, with sleep apnea symptoms showing up before any TMJ issues become apparent.
Obstructive sleep apnea is the most common form of the disorder, in which the airway becomes blocked during sleep, disrupting normal breathing. According to the National Sleep Foundation, more than 18 million Americans have the condition. Most who do probably don’t know it. (A survey conducted in the Netherlands found that 4 out of 5 people who have sleep apnea are unaware that they do.)
And what blocks the airway? The tongue, the tissues lining the airway and muscles around the airway all relax during sleep. If they fall back and block the airway, the attempt to keep breathing creates the sound of snoring. Obese people are more at risk than others (more surrounding tissue), as are older people (loss of muscle tone).
But while snoring can be an obvious sign of OSA, not all with the condition snore. Here are some of the other signs of disrupted breathing during sleep:
- Choking or gasping during sleep
- Waking up tired
- Waking suddenly
- Morning headaches
- Fatigue and sleepiness through the day
- Decreased productivity
- High blood pressure
OSA can lead to insomnia and irregular sleep patterns, teeth grinding (bruxism), chronic allergies, earaches, acid reflux and hypertension. And it’s more than just a nuisance. It can be life-threatening. After all, when the upper airway is blocked, oxygen can’t get to the brain! This, in turn, affects other parts of your body – both organs and muscles (and your heart is one big muscle). It has been linked with conditions such as heart attack and stroke.
Clearly, doing nothing about it is NOT a great option.
But great options are available, including alternatives to CPAP, the commonly prescribed remedy that involves wearing a mask that blows air into the upper airway. The device works well, but many find it cumbersome and uncomfortable, and stop using it after a time.
When OSA is mild to moderate, oral appliance therapy may be used instead. In our office, in fact, it’s the first line of treatment in such cases. These custom appliances help hold the jaw low enough so that the upper airway is kept clear and oxygen can flow to the brain easier. There are “invisible” daytime appliances, as well, which help the tongue to rest as it should against the palate.
There are other things you can do, as well, to get the better of OSA, such as avoiding alcohol, quitting smoking (as if you needed one more reason to quit, right?), sleeping on your side and losing weight. In fact, the National Sleep Foundation considers weight loss the most important thing you can do in treating OSA.
And, of course, the healthy eating that brings about real and lasting weight loss should give your oral and overall health a boost, as well! (For more on fad diets vs. lifestyle change, read this excellent post over at The Healthy Omnivore.)