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CPAP masks and TMJ?
#1
CPAP masks and TMJ?
I was very excited for my machine and took to it with no problems.  I started using it around February of this year.  My sleep improved remarkably but I was still exceptionally sleepy throughout the day.
I've had headaches pretty much every day since puberty.  They're usually only a 1-2 on the pain scale- just enough to notice, but not enough to bother.  I've also had very mild TMJ for as long as I can remember.

I noticed I was getting more and more INTENSE, want-to-shoot-myself-in-the-foot, headaches.  Finally connected the headaches to the TMJ which had also been getting worse.  But why?  I got sick and didn't use my machine for a few days.  I had no intense headaches so I started googling if CPAP could cause them... which eventually lead me to the mask I was using (and LOVED- which was a nasal pillow).

As things would have it, I broke my shoulder shortly thereafter and then I needed surgery.  I couldn't use my machine, at all, for a month.  I was in agony, in many ways.. but, hey, I still wasn't having those horrific headaches lol.  I mentioned my theory to my sleep Dr and he arranged for me to get a new mask.  I've been using it for less than a week.

And guess what........ the headaches are back along with the TMJ.  What the heck?!  What I read about the nasal pillow is that sometimes, for some people, forcing your jaw to remain closed all night can worsen TMJ.  I went with a full face mask this time.  Why is it still an issue?

I'm a month post-op from my shoulder.  The bone was slow to heal and now I'm rejecting the absorbable sutures and developing sores from them.  I still can't sleep on my right side (I prefer my left, but alternate throughout the night).  I'm stuck in the sling for another month, but only when I'm away from my desk (almost never lol).  I stopped wearing it to bed a week after surgery, so at least there's that.
In short, I have a whole lot going on. Big Grin  I've been sleep deprived and cranky since I broke my arm on August 11 and I'm just beyond frustrated that the new mask hasn't been the magic wand I was hoping for.
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#2
RE: CPAP masks and TMJ?
I don't think I have tmj issues but pap has definitely altered both my tooth and jaw alignment. also caused some grinding of teeth, I'm told. I theorize that these are related to having too big a tongue in too small a mouth; pap keeping the airway open and in effect pushing the tongue forward; consciously moving lower jaw forward to an underbite position in order to make more tongue space and breath easier; and the soft cervical collar necessary for leaks and clusters of apnea forcing jaw closed, teeth together and generally less room for the tongue than with a relaxed jaw. I can imagine that these kinds of things would aggravate an existing tmj condition. also, I'm not sure but think I've read that grinding teeth can produce headaches. intuitively, at least, it makes sense to me that bruxism and tension are related.
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#3
RE: CPAP masks and TMJ?
All masks will exert some pressure to the "bite" either just under the nose or under the lips.  Either could impact TMJ.  Masks should be worn as loose as possible, not tight, definitely not to where they leave strap marks.  A very common issue is that many users make their too tight.  See the video fitting guide from any MFG for their masks.

See your dentist, or a dentist familiar with Apnea.  They make a "Mandibular Advancement Device (MAD)", very expensive and said by some to cure or eliminate the need for a CPAP machine, it usually doesn't.  They also make Bite Guards designed to manage teeth grinding/bruxism and can make molds to maintain jaw and tooth alignment.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#4
RE: CPAP masks and TMJ?
Thank you for the reply and sorry to hear you have had some difficulties as well.

I'm 44. Back in my early 20's, my teeth were in very bad shape (thanks, in part, to spitting out 4 kids in some five years lol). I had no income. My family had very limited means. While visiting my grandmother in a different State, she found a somewhat shady (but well-intentioned) dentist. Over a month, he pulled each and every one of my teeth- the good as well as the bad.
I got dentures soon after but never adapted to the lower ones. But I wear the uppers at all times- including sleep.

SO!- lol- teeth grinding isn't really an issue. I have Ehlers-Danlos (hypermobility type), though, so I do hyper-extend and subluxate this and that all the time and my jaw is one of those things. Not wearing my uppers makes it so much worse.
My kids used to pick on me when they were little and caught me in a very deep sleep. They said, even though my mouth was wide open, it looked like I could eat my jaw. Overbite, maybe? The masks keep my mouth closed though... ???

I've been trying to practice the mask... relaxing my jaw to open my mouth some. The mask does seem to put pressure on my jaw to make that overbite more pronounced? I'm not sure yet. I've had to tighten the straps because it wants to leak air at the bottom. Maybe the straps are too tight?

I don't have a problem keeping my airway open.... normally. I tend to sleep on my sides, as I wrote earlier. I used to pick on myself because I somewhat contort and put myself in a sort of relaxed headlock. There was an, I guess, instinctive reason for doing so. When I broke my arm and tried sleeping on my side, I had to keep my elbows tucked in with my hands near my stomach. I suffocated! Having them up keeps my airway wide open.

All of this sleeping stuff is just so frustrating.
Some 8+ years ago, lower back pain became debilitating. Various mattresses didn't help in the least. In desperation, I laid on an unused long desk and fell soundly to sleep. It's been my bed ever since lol. While my back loved it straight away, my hips suffered for a month or two while they adjusted. I've since padded the desk with afghans and one of those $10. mattress cushion/pads and it's even more perfect. I use fitted sheets and everything. It's been marvelous.

Then, until 2-3 years ago, I slept primarily on my stomach- completely flat with my hands under my thighs (palms against flesh). My reflux got too bad, though, and I had to train myself to sleep on my back and somewhat reclined. But keeping my legs straight, in that position, causes me to hyper-extend my knees which lead to insufferable knee pain. I had to learn to like pillows and to sleep on my sides which I came to love nearly as much as my stomach.

And now it's the masks and migraines *bangs head against wall*
I love CPAP. I especially love when I'm not lazy and put some distilled water in the fridge to use. I tried variously sized ice packs but they were all too big. I quickly learned that humidity suffocates me. Cold air though. Oh.My.Goodness. I absolutely love cold air.

I hate that I see my Dr. so infrequently and that he's too rushed to really SPEAK with me. He gave me an occipital block for migraines (which, very oddly enough, made me sleep 16 hours a day for nearly a month after). Now he wants to try botox. I found the connection between CPAP/TMJ/migraines on my own. He doesn't seem interested, in the least, in uncovering the CAUSE of these problems.
I hate the fact that I just went with the sleep study peoples recommendation of a new mask WITHOUT trying it with air first. I don't know how many times they (or my insurance) will let me switch to something new and that I just have to suck it up and suffer in the meantime.

Sorry for my life's story, lol. I guess I just needed to vent more than anything.
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#5
RE: CPAP masks and TMJ?
**EDIT**
BAH!- I lost my earlier Quick Edit.
Without the original ramble and rant... thank you, Bonjour. You snuck in while I was writing my essay Too-funny
I've not been to a dentist since my teeth were pulled back in 1997. I've not even had new dentures since around 1998.
I don't know if I could find someone for my unusual needs/complaints. (I live in a small town in the impoverished state of WV)

(I tried adding that to my original post but was told editing isn't allowed after 10 minutes)
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#6
RE: CPAP masks and TMJ?
whew, I'm so sorry to read of all your struggles. venting is good and this isn't a bad place to do it. many kind and sympathetic folks here and a few at least may commiserate with their own related experiences. I wish you the best in your search for relief.
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#7
RE: CPAP masks and TMJ?
(09-30-2018, 03:52 PM)Zhaylin Wrote:  (I live in a small town in the impoverished state of WV)

anywhere near Steubenville Ohio?  My son lives there.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#8
RE: CPAP masks and TMJ?
Thank you, Sheepless <3 

After reading Bonjour's post again and one of his links, I think I might alternate nights with my 2 masks and work some more on the seals and tightness levels.  Maybe the tightness alone is causing the headaches.  I've not noticed any marks with my full face mask, but I definitely had them with my nasal pillow!
I like to jimmy around with stuff.  Maybe I can craft something to help with the seals.

I am, by no means, giving up on my CPAP!  After all, thanks to YouTube, I found out how to change my air settings a short while after having my machine lol.  I love puzzles, solving minor mysteries and tracking down root causes of problems.  In the meantime, CBD recently became legal in my State and it does seem to help *some* with my migraines.

Plus, all of these problems are teaching me to be more assertive and ask more questions.  My p-doc prescribed Provigil eons ago for Excessive Daytime Sleepiness.  I took it for years and loved it.  Then my insurance refused to cover it.  When I had my new sleep study done and discovered Provigil was insurance approved for my problems, I asked my Sleep Dr..  He dragged his feet (in all fairness, though, he wanted to tweak the CPAP first).  I had to REALLY speak for myself before he finally caved.
(And now, after all that, Provigil barely works now-a-days Dielaughing  yet  Oh-jeez ).

It's a process.  I accept that.  Does the process have to take SO LONG though Too-funny
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#9
RE: CPAP masks and TMJ?
Have u found a solution yet? The mask makes my TMJ worse. Like u loved the nasal, but that made my tmj worse keeping my mouth closed. Then like you, i was switched to a full face madk, but the tension to keep mask on still aggravates jaw..

I have a mouth guard made by a tmj specialist, but i have no room for my tonge so I clench really hard and am ruining my teeth nerves.

Headaches and tension are so bad. I asked my dentist and he said that the direct links between tmj and sleep disorders is such a new field that there really isnt anyone leading the charge. Do u know if there are any trials or studies?

I really am in a bad place. I need tge CPAP,, I need my teeth. But using the cpap kills my tmj and the headaches are constant. I cant remember whixh is worse sleeping 2 to 3chours a night or being distracted from headaches all day.
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