Why does TMJ flare up at night?

You go to bed after a long day looking forward to some rest. But instead you end up tossing and turning in pain as your TMJ inexplicably flares up overnight. Why does the temporomandibular joint seem to rebel more at night?.

Nighttime TMJ flare-ups can be particularly frustrating and disruptive to your sleep and overall well-being.

Several factors contribute to the increased dysfunction of the TMJ during nighttime hours. One key factor is the relaxation of the body during sleep. While sleeping, your muscles, including those around the jaw, tend to relax significantly. For individuals with TMJ disorders, this relaxation can exacerbate existing issues. When the muscles around the jaw relax, it may lead to the misalignment or shifting of the TMJ, triggering discomfort and pain.

Additionally, nighttime can be a period of increased teeth grinding or clenching for many people, often caused by stress or subconscious habits. This excessive pressure placed on the jaw joint during these episodes can lead to inflammation and aggravate TMJ symptoms.

Furthermore, sleep positions can play a role in TMJ flare-ups. Sleeping on your stomach or with your head in certain positions can put additional stress on the TMJ, potentially leading to nighttime discomfort.

By recognizing these factors that amplify nighttime TMJ symptoms, you can take proactive steps to address them. Seeking treatment, practicing relaxation techniques, and adjusting your sleep position may help alleviate nighttime TMJ flare-ups and improve your overall sleep quality.

Why does TMJ flare up at night

TMJ Flare up due to Gravity and Fluid Accumulation

Fluid accumulation when lying down

When we lie down to sleep, fluids in the body tend to accumulate in various areas, including the tissues around the TMJ. This increased fluid accumulation can raise intracapsular pressure within the joint. The pressure buildup can potentially impinge on the sensitive structures of the TMJ, leading to discomfort and pain.

Gravity no longer fights jaw closure at night

During the day, gravity plays a role in helping to maintain the natural position of the jaw and reduce excessive clenching or muscle tension.

However, at night, when we’re lying flat, gravity is no longer working against the jaw’s closure. This means that the muscles around the jaw may have a greater tendency to clench and overload the joint, increasing the risk of TMJ issues.

These anatomical factors highlight why nighttime TMJ flare-ups are relatively common. Individuals experiencing such issues may benefit from addressing these factors through techniques such as proper sleep positioning or relaxation exercises to reduce muscle tension and discomfort during sleep.

Other Factors that cause TMJ to flare-up at Night

1. Clenching and Bruxism

Teeth grinding and clenching often worsens at night, which strains the TMJ. Contributing factors include:

  • Reduced stress and distraction at bedtime increases clenching.
  • Less muscle activity means chewing muscles more easily contract forcefully.
  • Reduced proprioception and reflexes when sleeping makes it harder to catch ourselves clenching.
  • Teeth grinding spikes during REM sleep when dreams are most vivid.

Managing bruxism is key to calming TMJ irritation at night when clenching runs unchecked. Using a specialized nightguard helps enormously.

2. Positioning and Comfort 

How you sleep also plays a role:

  • Side sleeping avoids an open bite but increases grinding. Sleeping on the painful side worsens symptoms.
  • Back sleeping lets the mouth fall open, straining ligaments over time.
  • Stomach sleeping twists the neck and strains the jaw.
  • Supportive pillows can take pressure off joints, but wrong pillows exacerbate problems.

Analyze your typical sleep position and pillow use to minimize strain.

3. Stress and Emotions

Mental health influences nighttime TMJ flares:

  • Bottled up stress or anxiety from the day often manifests once trying to sleep. This amps up clenching.
  • Depression and emotions like fear can trigger unconscious oral habits that stress the jaw overnight.
  • Poor sleep itself impairs healing and coping with discomfort. Insufficient sleep worsens pain sensitivity.

Release accumulated tension and improve sleep quality to ease the burden on your TMJ while sleeping.

Tips to help minimize nighttime TMJ symptoms

Reducing TMJ flare-ups at night requires a combination of lifestyle changes and relaxation techniques:

Sleep Position

Opt for a sleeping position that supports your jaw and neck. Sleeping on your back with a supportive pillow can help maintain proper alignment and reduce strain on the TMJ.

Avoid Pressure

Try not to sleep with your hand or arm under your cheek, as this can put pressure on the jaw joint.

Stress Reduction

Practice relaxation techniques before bedtime to reduce stress-related teeth grinding and clenching. Deep breathing exercises, meditation, or gentle yoga can be helpful.

Dietary Adjustments

Avoid consuming hard or chewy foods, caffeine, and alcohol close to bedtime, as they can exacerbate TMJ symptoms. Opt for a softer diet in the evening.

Oral Appliances

Consider using a dental splint or mouthguard prescribed by your dentist. These devices can help prevent teeth grinding and reduce pressure on the TMJ.

Warm Compress

Apply a warm, moist compress to the side of your face before bed. This can help relax jaw muscles and alleviate tension.

Pain Management

Over-the-counter pain relievers or anti-inflammatories can provide temporary relief from TMJ pain when used as directed. Consult with your healthcare provider before using any medication regularly.

Avoid Chewing Gum

Refrain from chewing gum or excessive gum-chewing during the day, as it can contribute to TMJ strain at night.


Stay hydrated throughout the day to prevent nighttime fluid retention, which can increase TMJ discomfort.

Consult a Specialist

If TMJ symptoms persist or worsen at night, consult with a healthcare provider or a TMJ specialist. They can provide a personalized treatment plan, which may include physical therapy, medication, or other interventions.

Final Note

The complex interplay of structural vulnerability, hormones, chemicals, emotions, and habits create the perfect storm for TMJ woes at night. Targeting those factors bringing on symptoms after dark allows you to rest more soundly and wake with less pain.

That said, you should keep in mind that individual experiences with TMJ flare-ups can vary. What works best for one person may not be as effective for another. Consulting with a healthcare professional or a dentist who specializes in TMJ disorders can help you develop a tailored strategy for managing nighttime TMJ symptoms.

Don’t let your TMJ rob you of rest – equip yourself to sleep better in spite of dysfunction.


  • Editorial team

    A team comprising oral health care professionals, researchers, and professional Writers, striving to impart you with the knowledge to improve your oral health, and that of your loved ones. 

  • Lilly

    Lilly, aka, Liza Lee, is a passionate community oral health officer and our lead writer. She's not only well-versed in performing a multitude of dental procedures, including preventive, restorative, and cosmetic, but also an avid writer. Driven by the significant oral health burden all around her, Lilly strives to build capacity and promote oral health. She envisions making a lasting impact by advancing research, prevention, and promotion efforts to alleviate oral health disparities. Please share your views and opinions on my posts.

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