Clenching during sleep

[fourleaf]

Has anyone ever felt here that upon awakening that for whatever reasons there is a flare up starting? Could it be analogous to the clenching that someone with TMJ does as related to their jaw muscles? Stress related clenching during sleep may be responsible for some flares? How possibly can one control that? Or in sleep are the pelvic muscles more relaxed?

I certainly agree that pelvic floor clenching is responsible for a variety of symptoms we all experience but if we re-learn how to relax the tense muscles will they be less likely to clench during sleep?

I have a relatively unusual presentation I believe... flow issues for years and years that have morphed into frequency and now groin achiness rather acutely. I have had the flow issues dealt with some success surgically (TUIP only after video urodynamics) and have done internal/external PT as well as stretching, attempts at relaxation and Quercetin. All in all things have improved greatly since they started 6 months ago. Near normal urinary frequency the majority of the time but periodically that unsettling feeling that my bladder is irritated (this is much better than before). I believe I am on the right path and have this site to thank for that. But there are mornings that seem worse than others and believe there is some subconscious pelvic floor clenching that set me up for a mini flare. Anyone have insight on this?

[webslave]

That's an interesting question nobody has raised before. Clenching the jaw is easy to do when sleeping, but I'm not so sure about clenching the pelvic floor. Most men feel better in the morning and get steadily worse as the day wears on, which suggest that sleep is a time of pelvic floor relaxation. I suppose that if your life is very, very stressful, and your sleep fitful and disturbed, the pelvic floor could be involved.

[guy97]

Oddly, I tend to feel worse in the morning, and my most painful urination is typically the first one...

But I don't suffer from frequency issues. So my issue may be completely different somehow.

[BrettP]

It depends on variety of factors for me. If my bowels are in distress, the first thing I wake up with cramps and urinary pain. Otherwise I'm good in the morning and it progressively gets worse.

The absolute worst though is when you have morning wood with painful urination. That Is the pits and happens every now and then. But I assume if morning wood you could be spasming or clenching though I'm sure it's individual.

[fourleaf]

Thanks guys. I'm not sure that there is pelvic floor clenching during sleep but I cannot otherwise explain why I go to bed feeling essentially normal and then upon awakening have the start of a flare. My flares usually consist of the feelings of poor urination (feels like I have to strain and that I do not empty all the way). Then I continue to feel bladder irritation of varying degrees throughout the day. Lately it has been manageable... when all this started 6-7 months ago I felt that I had to urinate every 1/2-1 hour. Now I may have the feeling but can ignore it and it will mostly pass. Then there are days (many in a row) that things are OK and I don't "think" about urinating at all (other than normally). The only pain I have is really more an irritating ache in my groin. At first it was only my left but now it's both. Not so bad that I would even need to treat it but I certainly notice it as a new symptom.
I don't know but part of the frustration I feel with this condition is that I'm constantly trying to figure out what helps, what doesn't and to see if there really is a connection or it's "just in my mind". I often second guess myself. I guess as long as the overall direction is forward then I just keep on keepin on. I tried not sitting as much throughout my day and that does seem to help some.
I find solace and optimism in other's posts here and am thankful for this board. I don't know if we all suffer the same thing or we do and just manifest it differently but it's clear to me that the majority of the medical profession has little to offer guys like us. Before I found this board I felt like someone floating in the middle of the ocean without any direction or plan. I now have a plan... and that by itself makes a big difference in one's outlook. Good luck to all...
PS -- Anyone who suffers similar symptoms as I do I would love to hear what specifically helps your symptoms... especially the flow issues and the frequency issue. Thanks to all...

[casperach]

Three things I have heard (neither dealing with sleep though)

1. Dr. Potts mentioned to me that TMJ may have some connection and that I needed to learn to rest my jaw.
2. My sister was told by a doctor once that the jaw and pelvis are connected in a way that TMJ can cause pelvic pain.
3. My mother has both Fibro and TMJ and University Hospitals in Cleveland pointed out that a parent with muscle issues is important to note.

[Bossman]

Fourleaf,

Just wanted to chime in here. I both clench my jaw (have to wear a nightguard) and my pelvic region during my sleep (I sometimes wake up in pain if I am having a stressful dream, etc), so I believe the problems can definitely be related. The only things that I have found that help the problems are trigger point massages in the neck, and then stretching before bed. I think I have a bad habit of being active all day and then just hopping into bed without giving my brain a chance to relax. If I take the time to stretch and do some breathing exercises beforehand, I not only get a better night's sleep, but also wake up with a relaxed pelvic floor.

Bossman

[gl0342]

Fourleaf

My two cents (after coming back from the WA clinic this week):

1) Both issues are related somehow to Trigger Points. Suggest you get Clair Davies book, and you can find there TPs relating to the jaw, there are many. I have some bad around the jaw, Tim did some release on those, quite painful.

If you have TPs in some areas (e.g. pelvic floor), you are likely to have a tendency to have TPs in other areas (e.g jaws), more than the average/typical TP in neck&shoulder that most of us have.

What Clair Davies writes is that often TPs in the jaw area are misdiagnosed as TMJ.

2) We also discussed the issue of morning vs rest of the day - the experience is of primarily feeling worse in the morning by most people (mainly because TPs do not like static positions and especially the ones which "shorten" the muscles.

3) An interesting new subject that Dr Wise presented is his finding (which is presented in his Paradoxical Relaxation book and is likely to be in included in the 7th edition of Headache in the Pelvis (2012?), that there are specific patterns of tension (and therefore TPs) which connect different parts of the body. For example, when someone contracts the jaw, he may feel a contraction in the Rectus Abdomini (in my case it is also followed by a urethral sphincter spasm).

Hope this makes sense to you.

George

[neue01]

Hey there. I also have the same issue with mornings. I tend to feel worst when I wake up and then get better through the day. In the evening I'm usually feeling alright by the time I hit the sack. Then on waking again it all starts over. I've gotten better through the last year but mornings are where my symptoms tend to show up the most. I think there is something to do with clenching, holding in urine, and night time erections that aggravate the pelvic floor. This just seems obvious to me and I would think all of us would be dealing with this situation?

[gl0342]

Neue hi

I read some of your past threads and it seems you have been working for years trying to more or less improvise your own protocol.

Suggest you give a call to Dr Wise and discuss your case, he is very open and reachable, always returns calls, I think you may appreciate his insight. At this stage they have the best experience with identifying and mapping trigger points related to pelvic pain, external and internal. At least you should try and see their TP Tim Sawyer, even once, so that you get a conclusive mapping, and some minimal guidance.

Also do not underestimate the importance of the other components - aerobic exercise 30 mins/day, skin rolling several times a day, stretching, and most important deep relaxation, morning and evening. TP release itself (assuming it is done right which is not easy especially without coaching and the right tool), is likely not to be enough to rehabilitate the tissue.

Best
George

[jcacciat]

gl0342,

I am new here. I've read HITP recently. I understand the elements of the protocol involving TP release, aerobic exercise, skin rolling, and stretching. My question relates to deep relaxation as stated in your post. What I got from the book is that paradoxical relaxation is almost impossible to learn without some professional guidance, and I am not going to find that without traveling a great distance. So when you refer to "deep relaxation," is there some technique that I can learn from a relaxation therapist who is not trained in paradoxical relaxation?

Also, my symptoms tend to appear shortly after awakening, but are reduced after my morning jog (most days), and then get worse again in the late afternoon/evening. I clench my jaw at night and always have. Never would have guessed there could be a connection.

[Nevilleb]

Whats the treatment for TMJ?

Have been doing neck exercises and I've started to clench my teeth at night. I also have tinnitus which I've heard can be related to TMJ.

Who is the right person to see?

[Jay]

Whats the treatment for TMJ?

Have been doing neck exercises and I've started to clench my teeth at night. I also have tinnitus which I've heard can be related to TMJ.

Who is the right person to see?

The treatment for TMJ depends upon the cause, as does the proper person to see. There's no medical specialty dedicated specifically to it, because the name TMJ actually refers to several different disorders.

If you are seeing a physical therapist, you could consider asking them about treatment references, as many PTs do have an understanding of TMJ - it can have musculoskeletal/trigger point origins. You can also see your regular physician, an ear/nose/throat doctor, a dentist with proper training, or even a doctor at a hospital/university-based setting.

Where you end up would really depend upon the diagnosis and, assuming TMJ, the cause.

[graeme]

The bladder holds very strong urine during night which is often why that first wee in the morning flares people, it can irritate while sitting in the the bladder undiluted for so long during the night.

[suineg]

I woke up last week feeling like someone had a knife up my butt. Once I realized as I was laying there that I was tensing my pelvic floor, I released it and the sensation diminished. It started another flare for me. I also clench my teeth while sleeping.