To sleep—perchance to dream. Ay, there’s the rub!

To sleep, perchance to dream

by Gemita - 2021-07-08 04:19:20

Hello Simon, 

To sleep, perchance to dream . . . sounds just wonderful and the medicine we all need right now.  Oh why is life so complicated.   

Your teeth grinding (bruxism) may have always been there to a lesser degree and has only now perhaps become apparent.  I do not believe we can say with any certainty that your pacemaker itself has been the cause and clearly your symptoms lessen or disappear on rising because you stop the grinding.  The new right side sleep position could well be making your symptoms worse, but is it the sole cause.  I doubt it.  You could get jaw discomfort from your heart condition as well of course.  I have in the past during a fast arrhythmia.

I got jaw pain, neck and clavicular pain following my implant procedure, but I had evidence of a subclavian vein trauma/partial obstruction from pacemaker lead placement.  The pain eased when I developed good collateral circulation (collateral veins - now highly visible around my device), to help with blood flow.  So complications following the implant procedure itself could I suppose trigger unwanted chronic pain symptoms but bruxism?  

My feeling is that this is more likely to be connected to your other health condition, Marfan Syndrome, or possibly even stroke related?  It can occur following a stroke.  There are good treatments available for bruxism depending on cause.

You could also check for sleep apnea by having a full sleep study if you haven’t already done so.  A sleep study can give useful information about our habits at night.   Sleep apnea can be a cause for bruxism too.

Personally I can only see the pacemaker as an asset at night rather than a cause for your difficulties.  As your medical cousin with Ehlers Danlos Syndrome, I also tend to have a narrow jaw and high-arched palate, and as you know this can create dental and orthodontic problems which can increase over time.  I also get temporomandibular joint problems, which got worse when I was anxious about my health some years ago (prior to pacemaker).  Now it is under control although it can flare up and make “chewing/jaw moving” a painful and unpleasant experience. My doctors also found I was low in magnesium, calcium and Vit D.  Maybe get a vitamin/mineral and other blood checks.

You may need an opinion from an oral and maxillofacial consultant Simon, I did, or a sleep consultant and of course your dentist on the best way forward to protect your teeth and to find a way to have a better night’s sleep.

Check your medication too.  Bruxism may be related, for example, to some anti depressants like Prozac and other meds and I attach a link which might be worth a read Simon.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698238/

Another interesting link which confirms teeth grinding is a common occurrence in the population, has been associated with alterations in the autonomic nervous system which may trigger arrhythmias:-

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092563/

Lots of reading I know but all potentially helpful and might start to answer some of our many questions.  Hope otherwise you are doing okay.  I wish you a peaceful night's sleep

Glad you responded to the post!

by simonsimon - 2021-07-08 17:44:16

I was going to send you this message. Right now the  Marfan Foundation is having theier annual conference online. I saw this workshop and thought of you. It's free and pre-recorded. Might be wirth a look. Thanks again for the information!

WHAT’S NEW IN LOEYS-DIETZ SYNDROME RESEARCH Q&A

https://www.marfanfoundationconference.org/session/whats-new-in-lds-research-qa/
 

Thank you Simon

by Gemita - 2021-07-08 19:11:35

Just had a quick peep.  Will enjoy it tomorrow after a good night's sleep!  There is something on Bone Health which interests me since I have Osteoporosis of the spine.

Teeth grinding ( bruxism)

by Selwyn - 2021-07-09 08:08:19

Teeth grinding is associated with anxieties. Having a pacemaker is to some extent an anxiety. 

Teeth grinding is associated with pain around the jaw, headaches, migraines etc.

My wife (after all she is married to me for 40+ years,  so has some anxiety!) has a night splint to wear. This prevents the problem of complications, but  does not treat the underlying cause. Our dentist fixed her up with the night splint which is a little like a gum shield.

Heart pain, as in angina, can radiate up to the jaw. 

TMJ and sleeping

by asully - 2021-07-10 02:42:44

I too suffer from quite awful TMJ pain and TMD as well as bruxism.  It's hereditary for me, on my mother's side (well the TMD that it). I pop every time I open my mouth.  I have terrible bruxism at night wich probably aggravates it.  I have noticed that my sleeping position will affect wich side locks and hurts!  I normally sleep on my left side and this happens to be the side where I have literally ground down my back molars almost to the point of needing to get them capped.  I had a plastic night guard made by my dentist, it helps with the bruxism damage but I found it made me clench even harder causing more TMJ pain.  The absolute best treatment I ever did for both was Botox injections in the jaw muscles!  Insurance sometimes will cover it but I found it really wasn't that expensive and so far the results have lasted about 2 years.  After the injections the muscles shrink from not being used causing less clenching and grinding.  It also got rid of most of the migraines and tension aches from the TMD and has only started to get bad the last six months or so (so about 1.5 year of good relief).  I highly recommend this treatment to anyone who has the option and suffers TMJ pain!

Thanks for the comments and ideas

by simonsimon - 2021-07-12 23:19:03

that really gives me something to consider!