The question comes up, what does airway have to do with TMD or what does TMD have to with airway problems? And the answer is sometimes there's very little overlap, sometimes there's quite a bit of overlap, and sometimes there's total overlap.
What is Upper Airway Resistance Syndrome?
For example, Dr. Christian Guilleminault who is the head of the sleep center at Stanford University has been there for many, many years, since the late '70s. He describes a syndrome called Upper Airway Resistance Syndrome (UARS) where someone has difficulty breathing through their nose and so they breathe through their mouths.
He talks about populations of young adults, particularly females, who in their 20s will come into their clinics and have sleep studies. They often demonstrate that they do have struggles with their airway, all the way through the night, not really sleep apnea, but definitely struggling to breathe and working hard all night. This leads to creating sympathetic nervous system response, sort of fight or flight response and wavering in and out of light sleep and deep sleep and back and forth.
Forward head posture can also be a determinant.
But a classic example of typical symptoms for this Upper Airway Resistance Syndrome would be forward head posture, neck bothers me, feel tired during the day. My jaw muscles are sore. My joints may be sore. I frequently wake up with headaches in the morning, sometimes clenching and grinding my teeth.
Is this TMD or UARS?
Now, for us in dentistry, for as long as I've been involved in the field, we would call that a classic example of TMD. For Dr. Guilleminault and the physicians in California, at Stanford, they would say that's a classic example of Upper Airway Resistance Syndrome. Who's right? We're both right. It's just that we need to understand the relationship that can occur between these two things. So there is often a relationship between Upper Airway Resistance Syndrome, sleep disorders, breathing disorders and TMD signs and symptoms.