Why does my sleep apnea mouth guard make my jaw hurt?


Why does my sleep apnea device cause TMJ pain?
Why does my sleep apnea device cause TMJ pain?

Why does my sleep apnea mouth guard make my jaw hurt?

Recurrent obstructions of the upper airway characterize obstructive sleep apnea (OSA), often leading to oxygen desaturations and arousals from sleep (American Academy of Sleep Medicine, 1999).

Although sleep apnea treatment’s gold standard is a CPAP machine, sleep apnea mouth appliances (or oral appliances) are becoming more popular.

The mandibular advancement device therapy is increasingly recognized as a viable treatment for OSA (Aarab, Lobbezoo, Hamburger, & Naeije, 2011; Ramar et al., 2015).

How do sleep apnea mouth guards work?

Dentists custom-make sleep apnea mouth guards or oral appliances using a plastic-like mold to conform to the specific shape of the patient’s teeth and mouth.

Without getting into much detail, most sleep apnea mouthpieces work by moving the jaw forward. This protrudes the mandible and improves upper airway patency by enlarging the upper airway and/or by reducing its collapsibility.

Of note, the mandible, the bottom bone connected to the bottom teeth, houses the condyles that create both temporomandibular joints (TMJ), as shown in the picture.

Why does my sleep apnea mouth guard make my jaw hurt?

Due to their design, mandibular advancement device therapies exert additional forces on the teeth, oral soft tissues, and the musculoskeletal system.

In particular, temporomandibular disorder (TMD) highly affects the mastication system, including the masseter, temporalis, and lateral pterygoid musculature. Collectively, people refer to the pain and impairments associated with this area as TMD.

TMD is defined as a subgroup of craniofacial pain disorders that involve the temporo-mandibular joint, the masticatory muscle system, and associated muscles and soft tissues of the head, face and neck.

The oral appliance could impact both the muscles and joints, or individually.

If your jaw continues to hurt while you wear your device, speak to your dentist or other provider that prescribed the device.

Consider referring or consulting with a manual and rehabilitative clinician, such as a physical therapist, to ensure you can continue using your device to receive the full health benefit.


Managing TMJ effectively requires a collaborative effort, as it takes a dedicated team of healthcare professionals, dentists, and individuals to find the right strategies for relief and support.

We recommend seeking professional evaluation and guidance to better understand and address TMJ pain.

Patients presenting with TMD should consider specialized physical therapy.   We provide a comprehensive treatment approach through our TMJ Alignment and Relief Program. 

Don’t hesitate to contact us today so we can help you!