Self-Help for TMJ Pain

Self-Help for TMJ Pain

Temporomandibular Joint Disorder, or TMD, is a condition that causes a lot of pain and inconvenience for people suffering from it. Apart from orofacial pain, jaw pain, and difficult jaw movements, Temporomandibular Dysfunction can come with earache, migraines, dizziness, and more.

Temporomandibular Joint Pain, or TMJ pain, can be both acute and chronic, but in any case, it can seriously affect the quality of life. If you experience the symptoms of TMD, be sure to make an appointment with your dentist. A neuromuscular dentist can diagnose Temporomandibular Joint Disorder, help you to find adequate treatment and advise you further on remedies.

However, in addition to traditional treatment options, evidence shows that TMD symptoms can be alleviated or eliminated by exercise and a few lifestyle changes.

What is a Temporomandibular Joint Disorder?

The Temporomandibular Joint, or TMJ, is the joint that connects the lower jaw to the skull. Any condition causing pain or discomfort in these joints or the muscles that nest them is included in the term “Temporomandibular Joint Disorder.”

TMD can have a lot of different origins: the grinding of the teeth while awake or asleep, trauma of the jaw, or even stress. Temporomandibular Dysfunction can also come from Rheumatoid Arthritis or calcium and magnesium deficiency. Finding the cause of your Temporomandibular Disorder can be part of your treatment.

The Treatment of the Temporomandibular Joint Disorder

If you suffer from Temporomandibular Disorder, your dentist will recommend treatment options, perhaps even several of them simultaneously. They may prescribe pain relievers and anti-inflammatories to help ease the pain caused by TMJ disorders. For bruxism, they can prescribe tricyclic antidepressants and muscle relaxants.

Physical therapy, including ultrasound treatment or jaw muscle exercises, can ease facial pain and muscle stiffness. An oral appliance, like an oral splint or a mouth guard, prevents teeth grinding and can alleviate jaw pain. Counseling can help you identify and understand the stress factors aggravating your TMD. And, if nothing else helps, there is always surgery as a last resort.

You should also know that there is no underlying evidence that bad bites could develop TMD. Therefore, healthcare providers strictly advise against treatments that permanently change jaw joints, teeth, or bite unless necessary.

Home Remedies and Treatment Options for TMJ Disorders and TMJ Pain

In some cases, Temporomandibular Joint Disorder is only temporary and goes away without significant medical interference. If you experience facial pain or jaw pain, you can try to apply hot or cold packs on the painful area.

You can also try some over-the-counter medications. Non-steroidal anti-inflammatory drugs (NSAIDs) containing ibuprofen, such as Advil or Motrin, can effectively reduce pain.

Relaxation Techniques for Temporomandibular Disorders

While stressed, you often clench your teeth, tense your facial and shoulder muscles or chew on something hard, like a pen or a pencil – some even bite their fingernails. All these can lead to and aggravate temporomandibular disorders. Thankfully, learning to manage stress effectively can help eliminate these bad habits. Not only your jaw joints will be grateful, but better stress management also improves your overall well-being. Yoga and meditation can both be very effective against stress, as well as temporomandibular joint disorder.

You can also try the following exercise to help ease symptoms of Temporomandibular Joint Disorder:

  • First, sit in a comfortable chair with a good, neutral posture.
  • Now lower your head until your chin is resting comfortably on your chest.
  • Interlock your fingers and place your hand gently on the back of your head. Don’t push.
  • Now lift your head against the gentle resistance of your hands. Be careful not to push or force your head.

Jaw Exercises for Treating TMJ Pain

Strengthening the muscles around the temporomandibular joint can also effectively relieve pain caused by Temporomandibular Joint Disorder. Here are some exercises to help:

  • Sit in a comfortable chair with a good, neutral posture.
  • Close your mouth loosely, with your upper and lower teeth touching. Be careful not to clench your jaw!
  • Touch your upper teeth with the tip of your tongue.
  • Run the tip of your tongue backward on the roof of your mouth to the soft palate, as far as you comfortably can. Keep your teeth together, but do not clench!
  • Open your mouth slowly until you feel your tongue leaving your palate.
  • Maintain this position for five seconds, then relax.

Do this activity for five minutes two times per day.

The following exercise both relaxes and strengthens your jaw muscles:

  • Sit in a comfortable chair with a good, neutral posture.
  • Trace your lower jaw joint with your index finger on the right side of your face, and with a downward motion give the muscles a gentle massage.
  • Repeat on the left side.
  • Open your mouth comfortably and slide the tip of your tongue on your palette from your front teeth to the soft palette. Hold for five seconds.
  • Stick your tongue out as far as you can and stretch for five seconds.

You can repeat this exercise 5-10 times per day.

Another effective exercise is opening and closing your mouth with resistance.

  • Place your thumbs under your chin and open your jaw applying gentle pressure with the thumbs.
  • Place your index fingers on your chin, below your lower lip, and close your mouth applying gentle pressure to the area.

These two motions can be done separately or together in one fluid motion.

When you start exercising, you may experience some pain or soreness that will go away after one or two weeks. If during the exercise some TMD symptoms occur, such as popping or clicking and pain, stop the exercise and start again more carefully.

You can also speak with a TMJ specialist to learn more about these and other exercises.

Lifestyle Changes to Treat Your TMJ Disorder

It is important to find out what aggravates your TMD. For example, it can be foods you eat often, activities you enjoy, or your posture when you sit or stand – and a lot of other things.

Until you find the reason, you can significantly reduce the pain and inconvenience caused by Temporomandibular Dysfunction by applying these few lifestyle changes:

  • Avoid chewing gum and try to eat softer food. Try to eat also in smaller mouthfuls, so you don’t have to open your mouth as wide while eating.
  • Always keep your lips together and your teeth apart.
  • Hold your phone in your hand, not between your ear and shoulder.
  • Follow a diet rich in calcium and magnesium or take food supplements.
  • Treat stress consciously and reduce bad habits like jaw clenching or teeth grinding.

Temporomandibular Joint Disorder symptoms often ease with these technics, but in any case, make an appointment with a dentist who specializes in TMJ disorders, who can diagnose you and advise additional remedies.

Take the first step towards managing your TMJ pain. Schedule your consultation with the TMJ experts at Sleep Better Columbus online or call 614-777-7350.

Chronic Headaches Can Be Caused by TMJ Dysfunction

Chronic Headaches Can Be Caused by TMJ Dysfunction

The second-most common cause of chronic headaches is temporomandibular disorder (TMD), which is sometimes called TMJ dysfunction. These TMD headaches can greatly diminish quality of life. Thankfully, non-invasive treatment options can reduce or eliminate your chronic TMD headache.

What is a Temporomandibular Disorder?

A temporomandibular disorder (TMD) is a disorder of the temporomandibular joints, jaw, muscles, and nerves associated with chronic facial pain. TMD causes pain in the jaw joints and the muscles and ligaments controlling your jaw’s movement. Temporomandibular dysfunctions or disorders (TMD), can have a significant impact on your life by affecting your ability to chew, yawn, or speak easily.

Why Do Temporomandibular Disorders Cause Headaches?

Temporomandibular disorders cause headaches because the proximity of the jaw to the head means pain easily travels upward. The many nerves located near the temporomandibular joint contribute to the aches becoming more intense. The two primary reasons for a TMD headache are jaw tension and a misaligned bite.

Jaw tension is the most common cause of a temporomandibular disorder headache. Bruxism, the act of clenching your teeth, tires the muscles and joints surrounding the teeth, which causes joint pain and can wear down the teeth. Pain from the jaw travels up to the temples and can range from mild to severe. Grinding your teeth can also cause cramping of the jaw which can result in pulsating headaches that feel like migraines.

A misaligned bite puts strain on your jaw and is another common reason for a TMD headache. Trying to keep the jaw in proper positioning stresses and tires the tissues, including the facial muscles, surrounding the temporomandibular joint, and when this occurs, it causes a headache.

What are the Symptoms of a TMD Headache?

A TMD headache is pain in the head, face, and cheek caused by a temporomandibular joint disorder. The TMJ disorder causes pain in the temporomandibular joint, and that pain spreads upward to other parts of your head.

Frequent headaches can be symptomatic of TMJ issues. Common symptoms of TMD headaches may also include:

  • achiness in your neck and/or shoulders
  • atypical pain in your cheek muscles
  • challenges with swallowing
  • clicking or popping sounds when moving your jaw
  • difficulty or pain when chewing food (more severe head pain may occur when chewing)
  • inability to open your mouth fully
  • migraine headaches
  • pain over your eyes, in the ear area, or in the temples
  • sore TMJ (jaw) hinges
  • sensitive teeth, but no obvious dental problems
  • swollen face
  • tinnitus (ringing in the ears)

How is Temporomandibular Dysfunction Diagnosed?

Dentists, physiotherapists, or doctors can diagnose temporomandibular dysfunction (TMD) in a dental checkup or physical examination. They will assess your jaw’s range of motion when you open and close your mouth, feel the areas surrounding your temporomandibular (jaw) joints while you open and close your mouth, and press on your jaw and certain areas of your face to find areas of tenderness, pain, or discomfort.

They might also use imaging tests for a closer look at your temporomandibular joints and the structures surrounding them. The imaging tests might include a panoramic X-ray to assess your jaw and teeth, a CT (computed tomography) scan to get a more detailed view, and an MRI (magnetic resonance imaging) to assess the soft tissues that surround your temporomandibular joints.

Treating Temporomandibular Joint Disorders and TMD Headaches

The underlying cause of your temporomandibular joint disorder (TMJ) and the severity of your pain are two factors that are taken into consideration when determining the TMJ treatment that is right for you. Noninvasive options should be tried first. Treatment options can include home remedies, medications, self-managed care, and/or other nonsurgical treatments.

Home Remedies and Medications

Home remedies include eating soft foods, applying heat or cold packs to the affected area, and taking over-the-counter pain medications like ibuprofen, acetaminophen, or naproxen. Home remedies may help reduce the pain, but they are temporary solutions that won’t always resolve the problems long-term.

Sedatives and muscle relaxers can also help treat TMJ disorders. Sedatives can help you sleep more peacefully at night. Muscle relaxers relax the muscles in the area and are often paired with pain relievers that help with immediate pain.

Self-managed Care

Self-managed care treatment options include any activities you can do yourself. These activities might be learning all that you can about your type of temporomandibular joint disorder, identifying any activities that can contribute to TMD flare-ups, setting specific goals for managing your TMD, and learning relaxation techniques or meditation to reduce and/or eliminate any stress that could contribute to TMJ pain or lead to habits that cause TMJ pain (e.g., chewing on non-food items, clenching teeth, grinding teeth).

Other Nonsurgical Treatments for your TMD Headache and TMJ Pain

Additional nonsurgical treatment options like oral appliances and physical therapy do not involve medications. Oral appliances include bite guards that can be worn while you sleep or occasionally during the day, and wearing a dental splint or mouth guard to realign the jaw. Physical therapy for Aggressive Treatment Options for Severe TMD

For severe TMD, your dentist or doctor may suggest other more aggressive treatment options. Corticosteroid injections directly into the joint are often helpful. Arthrocentesis, a medical procedure during which the jaw joint is washed out with sterile fluid to rinse away any debris, may also provide relief. If these and other nonsurgical treatments are not effective, a surgical option may be suggested as a last resort. Surgical options are generally only used when there is something structurally wrong with the jaw joint of a patient who has a temporomandibular disorder.

To learn more about using oral appliances to treat TMJ and reduce or eliminate your TMD headaches, call Sleep Better Columbus at 614-777-7350 or contact us online to speak with a TMJ specialist.
TMJ: Causes of Temporomandibular Joint and Muscle Disorders

TMJ: Causes of Temporomandibular Joint and Muscle Disorders

The term TMJ Disorder or TMD refers to a group of conditions that affect the temporomandibular joint and the muscles around it. It’s estimated up to 10 million Americans experience the pain, discomfort, and dysfunction in the jaw joint and its surrounding muscles due to some form of TMD. However, the number could be even higher as many cases remain undiagnosed.

People with TMJ issues often don’t seek medical help because the symptoms are intermittent. Although they may manage the condition themselves, painkillers and heat/ice packs only alleviate symptoms temporarily and do not address the underlying issue.

What is a TMJ Disorder?

Although TMJ disorders can vary among individuals, medical professionals, and researchers agree that it can be classified into three basic categories.

1.     Myofascial Pain

Myofascial Pain is the most common type of TMJ disorder and involves discomfort or pain in the muscles that control jaw movement. Common symptoms of myofascial pain include headaches, earaches, soreness around the face, neck, and shoulders, and popping or clicking sounds when opening or closing the mouth.

2.     Internal Derangement of the Joint

When there is an injury to the condyle, a dislocated jaw, or a displaced disc, it is referred to as internal derangement of the joint. This type of disorder also causes pain and restricted movement, along with a grating sensation when attempting to open the mouth.

3.     Arthritis

Arthritis is the third category, which refers to a joint disorder that causes degeneration and inflammation. It can also affect the temporomandibular joint. Symptoms commonly associated with arthritis are joint stiffness, limited range of motion, and chronic pain.

A Combination of TMJ Disorders

When someone is diagnosed with TMJ, they may have one, two, or all three of the associated conditions. Additionally, there are other issues that can coincide with these joint disorders, such as fibromyalgia, sleep disturbances, and chronic fatigue syndrome. Many people with TMJ have a mild form and can collaborate with their dentists and physicians to develop an effective treatment strategy.

Who is at Risk of Developing TMD?

Having certain risk factors can increase an individual’s likelihood of developing TMJ, but it is possible to develop the disorder even without these factors. The presence of multiple risk factors increases the likelihood of having TMJ.

Continuously engaging in stress-related actions like clenching your jaw, biting your lip or objects, grinding your teeth, or chewing gum, ice, or taffy for extended periods can up your risk of developing TMJ. Certain medical conditions can also raise the risk of developing a joint disorder, particularly if you have a misaligned jaw, teeth, or bite. Having jaw or facial deformities may also cause problems with your temporomandibular joint. Conditions like rheumatoid arthritis and osteoarthritis can impact the temporomandibular joint. Additionally, an inflamed membrane lining the temporomandibular joint can cause TMJ. Fractures or dislocations of the face or jaw can also cause long-term problems.

TMJ is more commonly diagnosed in women than in men, with most cases occurring in individuals between the ages of 30 and 50. However, TMJ can also affect men, and elderly patients with poorly fitted dentures may be at risk of developing TMJ.

TMJ Disorder Treatment Options

The treatment for TMJ can vary depending on the cause and severity of your condition. The main objective of the treatment is to alleviate the pain and enhance the functioning of the jaw joint. Sleep Better Columbus‘ experts can assist you in identifying the probable cause of your TMJ and initiating a treatment plan that targets the underlying issue with your temporomandibular joint and surrounding muscle tissue, rather than just addressing the symptoms.

Strengthening Muscles and Reducing Jaw Clenching

The treatment options for your condition may involve physical therapy aimed at strengthening the muscles around the affected joint, as well as stretches to alleviate pain and promote muscle relaxation. Additionally, your dentist may suggest using a dental splint while you sleep to prevent teeth grinding and jaw clenching. If you participate in sports, your medical care may involve the use of a mouth guard to safeguard your teeth and jaw.

Lifestyle Changes

Simple changes to your lifestyle can help ease the pain and discomfort caused by TMJ. Proper posture maintenance, reducing stress, practicing relaxation techniques, and avoiding excessive chewing on non-food items, gum, taffy, and ice can significantly reduce or eliminate symptoms.

Medications and Procedures

You can use medications to treat TMJ symptoms. Taking pain relievers during the day can help alleviate any discomfort. Your dentist may recommend a muscle relaxant or sedative to take at night to help your body relax and prevent teeth grinding or jaw clenching. Often this can help reduce or eliminate nighttime jaw clenching and teeth grinding.

There are outpatient procedures available for TMJ treatment. One of them is joint irrigation, which involves rinsing away debris and has helped some patients. Surgery is usually a last resort and only recommended in extreme cases.

Consult the TMJ Disorder Specialists at Sleep Better Columbus

TMJ can be a painful and debilitating condition if left untreated. Fortunately, there are numerous treatment options available to help reduce the symptoms of TMJ and improve the functioning of the jaw joint.

Sleep Better Columbus‘ team of experienced dentists can assist you in finding a personalized solution for your TMJ condition and helping you enjoy life without pain or discomfort. With the right diagnosis and treatment plan, you can live a pain-free life with maximum jaw functioning. Contact us today to learn more about our comprehensive approach to treating TMJ disorders. We look forward to helping you find the ideal solution for your condition!

Call Sleep Better Columbus today at (614) 777-7350 or reach out to us online to see how we can help reduce your pain and help you sleep better tonight!

What is Sleep Medicine?

What is Sleep Medicine?

Getting a good night’s sleep can make or break your day when you wake up. If you’ve had a good night’s sleep then you’re feeling fresh to start your day. But the effects of sleep deprivation can cause you to wake up cranky, groggy, and feeling like you’re dragging all day long with excessive daytime sleepiness.

Just as there are many reasons why you may be sleep deprived, there are just as many ways to improve healthy sleep habits. Understanding what’s causing your poor sleep quality is just as important as improving it. Fixing your sleep issues isn’t always as easy as taking a sleeping pill or other sleep aids. Poor sleep quality could be a sign of a much more serious health problem.

That’s where sleep medicine comes in. It can determine if you have a sleep disorder or medical problem that is keeping you up all night. It’s estimated that 70 million Americans suffer from a sleep disorder. If you think you’re part of this group, you’re probably looking for help. That’s where seeking the help of a sleep medicine professional can change the way you sleep.

What is Sleep Medicine?

Sleep medicine takes a look at sleep disorders. When you see a doctor who is a sleep medicine specialist, they are trained to look for sleep disorders. An accredited sleep physician is familiar with a variety of sleep problems including:

  • Pediatric sleep problems
  • Circadian rhythm disorders
  • Restless leg syndrome
  • And a variety of other types of sleeping disorders and issues

Sleep medicine can help to treat several different types of issues. Let’s take a look at what a sleep medicine specialist can help treat.

Obstructive Sleep Apnea

Obstructive sleep apnea can be a serious condition. When someone has OSA, they may stop breathing frequently during the night. This can be due to a blocked airway, or the brain not sending the right signals to breathe. Throughout the night, people can stop breathing for as long as 40 seconds. During this time, your brain wakes up, causing you to move and resume breathing.

A common sign of OSA is snoring or a sound like someone is choking or gasping for air. Sleep apnea can cause the level of oxygen in the blood to drop. This leads to restlessness, waking up abruptly, and poor sleep.  Since OSA interrupts your sleep, you are left feeling groggy which can lead to poor productivity at work and can put you at a greater risk of getting into a car accident because you’re not as alert as you should be.

Many people don’t know they have this condition until someone observes them sleeping. They may feel fatigued, but not realize that they are suffering from obstructive sleep apnea.

Besides getting a poor night’s sleep, obstructive sleep apnea can also lead to high blood pressure, stroke, diabetes, and heart disease.  Several treatments can help improve poor sleep quality associated with OSA. This includes a customized mouth guard that’s worn at night or the use of a continuous positive airway pressure (CPAP) machine.

Many people with sleep apnea don’t like using continuous positive airway pressure machines and prefer an oral appliance to help them with their obstructive sleep apnea. At Sleep Better Columbus, we can help you find the one that is most comfortable and suits your needs. These oral appliances work to move the lower jaw forward to open the airway and unblock your windpipe. This can improve breathing at night and help people sleep better.

FDA-registered oral appliances can be used to treat sleep apnea when they are given by a qualified dentist trained in dental sleep medicine.

For some people, losing weight can also help to treat sleep apnea. Some people who are obese and suffer from OSA are advised to lose weight to also help with their apnea issues. But losing weight isn’t always enough. This is why it’s a good idea to request an appointment with someone experienced with the American Academy of Sleep Medicine as well as special training for diagnosing and treating OSA.

If you think you have sleep apnea, it’s best to get the treatment you need to get a better night’s sleep and improve your overall health.

Primary Insomnia

Besides sleep apnea, sleep medicine also addresses the issue of primary insomnia. You may be suffering from primary insomnia if you have trouble falling asleep or staying asleep, or waking up frequently during the night. If this happens for at least two weeks, you may be suffering from primary chronic insomnia.

Primary insomnia may be caused by anxiety, depression, too much caffeine, or certain medications. When you don’t sleep properly, your body is not getting the time it needs to repair and restore it. This leads to many problems including tiredness during the day and poor decision-making.

When your insomnia lasts for three months or more, it is considered chronic and can lead to even more problems. Seeking the help of a sleep medicine specialist can help to alleviate the problems that are leading to your insomnia.


When you’re asking what is sleep medicine, narcolepsy also needs to be addressed. Narcolepsy not only disrupts people’s sleep during the night but also makes them sleepy during the day. They feel overwhelmingly tired and have trouble fighting off the urge to sleep. Sometimes people even fall asleep while they’re trying to have a conversation.

This is especially dangerous because it can happen when people are driving and even eating. The dangers of this are obvious because people can get into an accident and even choke when they’re eating.

A sleep specialist can help people with narcolepsy so that they can feel more awake and not be at risk of hurting themselves or someone else.

Call us for Sleep Medicine Help

At Sleep Better Columbus, we want to help you sleep better. We can answer your questions when it comes to what is sleep medicine and provides you with the help you need to get a better night’s sleep. We are dedicated to staying on top of sleep research to be able to provide our patients with a diagnosis based on their unique symptoms. We’ll then provide a treatment program to help you improve your sleep hygiene to help put an end to your sleep disturbances and sleep problems. Dr. Mark Levy, a sleep specialist, and his team are trained in providing help to those suffering from sleep apnea.

They can help people with sleep apnea, snoring, and many of the conditions that can go along with them, like teeth grinding and fatigue. When you have your sleep issues addressed, you’ll regain your health, vitality, energy, and improve your overall quality of life. Dr. Levy and his team also help patients with sleep education and to understand the effects of sleep disorders. Healthy sleep behaviors and habits are vital to living a healthy, happy life.

The team at Sleep Better Columbus can help with diagnosis and testing. Request an appointment today at 614-362-7292 to find out more about sleep research and sleep hygiene and how sleep specialists can help you.

For Sleep Apnea, a Mouth Guard May be a Good Alternative to CPAP

For Sleep Apnea, a Mouth Guard May be a Good Alternative to CPAP

People with sleep apnea who can’t tolerate the noise and discomfort of a CPAP machine might benefit from a mouth guard or surgery.

By Nicholas Bakalar

Article Published May 31, 2021

Oral device that us used to treat sleep apnea

Many people wear a CPAP machine at night to treat the interrupted breathing of obstructive sleep apnea, a condition that affects an estimated 22 million Americans. But CPAP machines can be noisy, cumbersome and uncomfortable, and many people stop using the devices altogether, which can have dire long-term consequences.

Mouth guards may be a more comfortable and easy-to-use alternative for many people with obstructive sleep apnea, according to a new report. The study, published in Laryngoscope, looked at 347 people with sleep apnea who were fitted with a mouth guard by an otolaryngologist. Two-thirds of patients reported they were comfortable wearing the devices, and the devices appeared to be effective in helping to relieve the disordered breathing of obstructive sleep apnea.

The lead author of the study, Dr. Guillaume Buiret, head of otolaryngology at Valence Hospital in Valence, France, said that if he had sleep apnea, he would choose an oral appliance first.

“It’s easy to tolerate, effective and it costs a lot less than CPAP,” he said. “Thirty to 40 percent of our patients can’t use CPAP, and these patients almost always find the dental appliance helpful. I would recommend it as a first-line treatment”

Loud snoring may be the most obvious consequence of sleep apnea, but the condition, if left untreated, can lead to a broad range of complications, including high blood pressure, heart disease, liver dysfunction and Type 2 diabetes.

The problem develops when the soft tissue at the back of the throat collapses during sleep, blocking the airway. This leads to breathing cessation for brief periods, gasping for air, difficulty staying asleep, and all the problems of daytime sleepiness, from poor job performance to fatal accidents. Animals can have it too — bulldogs, for example, have a narrow airway and a soft palate that can easily block it. Their sleep apnea is almost identical to the human version.

The severity of the condition varies widely from a very mild problem that may need no treatment at all to severe or even life-threatening disease. Dr. Sara E. Benjamin, a neurologist and sleep specialist at Johns Hopkins, said that spending a night in a sleep laboratory monitored by a technician is the best way to diagnose apnea. A lab study offers the most thorough analysis, and can detect many other sleep problems besides apnea, but there are home test kits that are easy to use and cost-effective. They test breathing effort and oxygen levels, but not the brain waves, muscle tone and leg movements that a lab test records.

How can you know that you need a sleep assessment? “It’s a low standard to get evaluated, either by home testing or in a sleep lab,” Dr. Benjamin said. “If a person feels sleep problems are impacting daily activities, that’s enough to go and get evaluated. If the cause is a breathing problem, you don’t want to ignore it.”

A CPAP — continuous positive airway pressure — machine is usually the first option for treating sleep apnea. The device has a motor that delivers pressurized air through a tube attached to a mask that covers the nose, or both the nose and the mouth. This keeps the airway open. Some machines can automatically change the pressure to compensate for changes in sleep position; others require manual adjustment. Headgear varies, but all have adjustable straps to get the right fit. There are newer models that can deliver heated or humidified air, depending on the patient’s preferences, and there are small travel models as well.

“We recommend a custom device made by a dentist,” Dr. Benjamin said. “And you should be retested to see how well it’s working. There’s subjective and objective improvement that should be tracked.”

But there are people for whom neither CPAP nor dental appliances work, either because they cannot use them consistently or correctly, or because the devices themselves do not solve the problem even when used properly. For these patients, there are various effective surgical procedures.

The most common is soft tissue surgery, which involves modifying or excising tissue at the back of the mouth. Depending on the structures and musculature of the mouth, the surgeon can trim the soft palate and the uvula, remove the tonsils, shrink tissues with a heated instrument, straighten a deviated septum, or alter the position of the tongue muscles, all with the aim of improving air flow.
White plastic mouth guard for Obstructive Sleep Apnea by O2Vent Optima

There are also bone surgeries that move the jaw forward to make the entire breathing space larger, a procedure that can involve a protracted recovery period.

In 2014, the Food and Drug Administration approved a device called Inspire Upper Airway Stimulation. This is a small appliance implanted under the skin like a heart pacemaker. Using two electrical leads, it senses the breathing pattern and stimulates the nerve that controls the tongue to move it out of the way and allow air to pass freely. Implanting it is a day surgery procedure that takes about two hours.

“It doesn’t change the anatomy, and recovery is easier than with other surgeries,” said Dr. Maria V. Suurna, an associate professor of otolaryngology at Weill Cornell Medicine who specializes in surgery for sleep apnea. “It’s effective. It has the lowest complication rate of all the surgeries.

“But it’s not for everyone. It’s approved only for adults 18 and older who are not overweight and who have moderate to severe apnea.” Some people may be ineligible because of the structure of their anatomy.

“Surgery is tricky,” Dr. Suurna said. “But there’s no ideal treatment for apnea. Each has pros and cons, benefits and risks.”

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