Restless Legs Syndrome: Teeth Clenching Connection and Treatment

I have found it interesting to learn in addition to restless legs syndrome (RLS) and periodic limb movement disorder (PLMD), I have another sleep-related movement disorder that many are familiar with: sleep-related bruxism.

I don’t think I grind my teeth, but my dentist said I definitely clench them hard while sleeping. It is fascinating that these sleep phenomena have a connection. Fascinating, but not cool. Not cool because it has led to temporomandibular joint and muscle disorders (TMJ) and a whole lot of constant jaw pain.

I have heard people in groups refer to this connection as restless jaw syndrome. That made me curious enough to look up the connection between the two.

Connection between RLS and jaw grinding/clenching

Research connects RLS and bruxism that suggested as many as 40 percent of people with RLS have bruxism. A more recent study in 2019 had that around 33 percent. If they were comorbid conditions, that would just be interesting, but they also looked at potential treatment. And in particular, they looked at dopamine agonists as a treatment for both.^1-3

That one medication could treat both interests me a whole lot. It makes me think about what RLS medication I should be on for the most impact. And the one I am on, Levodopa, is not on that list. However, that seems like a real consideration if we have both of these when considering medication. Still, there are ways to manage mild to moderate TMJ without medication.

The problems with TMJ/TMD

Teeth clenching and/or grinding does a real number on the teeth, leading to more dental work. It also causes facial and jaw pain. I developed TMJ that then aggravates my migraine disease.

You can see how just this teeth clenching issue for me can cause some serious issues. I have chronic migraine disease. I do not need anything to aggravate those in any way. And it really does.

In fact, when I don’t have a migraine, I have a headache. That is likely from the TMJ itself. However, I have significant jaw and facial pain from TMJ, and I know it impacts my migraine disease.

I also have tinnitus (ringing in the ears), ear pain, neck and shoulder pain, and jaw popping. It is painful enough I have considered a lot of treatment options for it in the hopes of reducing it and helping with my migraine attacks at the same time.

Considering TMJ treatment options

Some potential TMJ treatment options include:

• Cognitive and behavioural: relaxation techniques, biofeedback
• Medications: Muscle relaxants, NSAIDs, antidepressants, and antiepileptic agents
• Physical therapy
• Surgery or injections. This can include botox therapy

If a simple medication change could reduce the jaw clenching and thus the pain I get in my jaw, this could have a significant impact on me. The main issue is that dopamine agonist medications, just like the medication I am on, can sometimes just be short-term due to augmentation.

Already on a muscle relaxant

Due to that fact, I am trying all sorts of different ways to manage the severity and frequency of my RLS. Nevertheless, I’d be willing to switch medications to get some relief from the bruxism that may reduce the symptoms of that, too, even if I don’t need the medication as much from alternative RLS treatments.

However, just looking at the list of potential TMJ treatments and medications, it actually turns out I was put on one used often for my fibromyalgia in the muscle relaxant category. This is a better treatment medication for me than a dopamine agonist that I don’t want to depend on.

Practicing jaw relaxation techniques

I also do jaw relaxation techniques pretty much all day. I have noticed I clench during the day consistently. With a lot of effort, I have learned to relax my jaw throughout the day. Not to mention avoiding things like chewing gum. A friend of mine with severe TMJ does Botox therapy for her's with some success. I was considering a night guard for my teeth clenching issue, but it turns out I cannot afford that.

It is interesting to see the connection between these evening/night movement disorders. Also, how we might effectively treat them. I am thinking those statistics are accurate since my spouse, who also moves around in his sleep (but doesn’t have RLS), has serious grinding teeth issues as well.

Do you have both of these? Do you find it further disrupts your sleep? I know I always wake up with a headache from the jaw clenching. Or has your medication effectively managed both conditions for you?