Could It Be My Pillow ?
Well chances are the little guy in the image above doesn't have any sleeping issues yet (at least not related to his jaw!) But for many people suffering from TMJ pain, figuring out how to sleep can sometimes be a real challenge.
As a chiropractor who treats TMJ issues along with spinal problems, it makes sense to me that sleep position can impact joints in the body. We see it all the time, especially in the neck. Often altering a patients sleep posture can make a world of difference in neck pain and arm numbness. With that said, there is surprisingly little research on the topic. Most "lay" literature regarding sleep position says to sleep on your back and not on your stomach, or on your sides if you can't make it on your back or you snore. We have found this generally to be true. We have also found that the thickness of the pillow you use is also very important, especially in cases of neck pain. For our neck pain patients that are side sleepers we recommend a pillow that is thick enough to keep your head elevated 75-90 degrees from your bed. To thick a pillow will crank your neck up, to thin and you run the risk of jamming your collar bones together and developing shoulder pain and arm numbness. For back sleepers a thinner pillow that only elevates the head 15-20 degrees from the bed is in order. Any thicker and you force your head into a "Forward Head Posture" and that creates a lot of issues with neck pain, headache, etc. Some people can get away with no pillow on their back (usually the younger crowd), but most people want something under their head. If you go back and forth between your side and back, getting a thin pillow for back sleeping and then doubling it over when on your side can be helpful. Another option is a pillow that is thick on the sides for side sleeping and thin in the middle for back sleeping. We have sold the D-Core in our office for the last 30 years, and I personally sleep on one.
What Does The Literature Say On Sleep Position and TMJ Issues?
Well, there seems to be even less research on that than on sleep position and spinal pain. There was a really nice article in 2005 from The Journal of Oral Rehabilitation This article looked at sleep position related to a specific TMJ issue called Anterior Disc Displacement Of 50 people with this issue on one side only, 33 (%66) of them slept on the same side they had the issue on. The article suggested that sleeping on the effected side may cause the TMJ to shift backwards and allow the disc to slide forward.
Again, you will find the lay literature recommending back sleeping to avoid pressure on the jaw. This makes sense and is backed up by research, especially for TMJ issues involving Anterior Disc Displacement.
One problem that back sleepers can be plagued with (or at least their spouses) is more snoring issues. So sleeping on your back may be good for you jaw, but might aggravate potential snoring issues.
What to Do ?
Let's combine best evidence with real life scenario for TMJ sufferers:
- If possible, sleep on your back with a thin pillow that only elevates your head 15-20 degrees
- If you can't seem to get to train yourself to sleep on your back, or you have trouble with snoring, shift to your side. Try not to sleep on the side of your TMJ pain. Use a pillow that elevates your head between 75 and 90 off the bed to avoid irritating your neck.
- If at all possible, stay off your stomach.
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If you find yourself switching between your side and back, get a pillow that is pretty thin for when you are on your back and then double it over if you shift to your side. Consider a D pillow (as described above).
If you are working on making a change, remember it can take a number of nights to get into a new routine, but it may be worth it in the long run if it reduces your TMJ pain!
If you have questions on your pillow or sleep position and would like to run it by somebody, we would be happy to talk with you on the phone, just give us a call.
Yours in Health,
Doug Williams, D.C.
TMJ Relief Center At Care Chiropractic
134 Executive Drive #3
Lafayette, Indiana
47905
(765) 448-6489
