A clicking noise heard during sleep often signals an involuntary movement or structural event occurring within the body. The causes generally fall into a few distinct categories, including mechanical issues in the jaw, movements of soft tissues in the airway, or less common neurological occurrences.
Mechanical Causes Related to the Jaw and Teeth
The most common source of a distinct clicking or popping sound during sleep originates from the temporomandibular joint (TMJ), the hinge connecting the lower jaw to the skull. The TMJ contains a small cartilage disc that cushions movement. When this disc slips out of position, the jaw movement causes an audible click or pop as the disc snaps back into place, a condition called disc displacement with reduction.
Nocturnal teeth grinding (bruxism) significantly contributes to TMJ dysfunction by placing pressure on the disc, causing it to become compressed or displaced. While bruxism produces a loud grinding noise from teeth rubbing together, the resulting strain can weaken the ligaments holding the TMJ disc, leading to the secondary, distinct click or pop of the joint. This mechanical joint noise signals that the jaw is not tracking smoothly and can lead to symptoms like pain, morning headaches, or restricted jaw opening.
Airway and Soft Tissue Sources of Sleep Sounds
Clicking can also originate from the involuntary movement of soft tissues in the throat and palate. One specific cause is palatal myoclonus, a condition involving rapid, rhythmic spasms of the soft palate muscle (the tissue at the back of the roof of the mouth). The clicking sound comes from the muscle twitching against the back of the throat and is often loud enough to be heard by others.
The rhythmic contractions of the muscle, specifically the tensor veli palatini, create an audible click that may be irregular or occur in bursts. This clicking is directly caused by involuntary muscle activity rather than structural joint friction.
Other soft tissue sounds are variants of typical snoring, where air turbulence causes the uvula or soft palate to vibrate. This turbulence occurs as the airway partially collapses during sleep, causing the soft tissues to flutter. These rapid vibrations can mimic a clicking sound, especially if the air movement is irregular.
Less Common Muscular and Neurological Explanations
Involuntary muscle spasms governed by the nervous system can also lead to sleep clicking. Sleep myoclonus includes hypnic jerks, which are sudden, brief muscle contractions occurring as a person drifts off to sleep. If these jerks involve the neck or jaw muscles, the abrupt movement can generate a single, loud clicking or popping sound.
Another distinct neurological source is middle ear myoclonus, involving the tiny tensor tympani and stapedius muscles. When these muscles contract involuntarily, they pull on the small bones of the middle ear, creating an internal clicking, crackling, or thumping noise heard by the patient. This sound is usually irregular and can interfere with sleep.
The tensor tympani muscle normally tightens to dampen loud sounds, but when it spasms, the resulting sound is perceived as a repetitive, irregular clicking. Unlike jaw or airway clicks, this sound is generated inside the ear and is a direct result of muscle twitching.
Diagnosis and Management Strategies
Addressing a persistent clicking noise during sleep requires accurately identifying the source through professional evaluation. If the clicking is accompanied by morning jaw pain, headaches, or difficulty opening the mouth fully, consult a dentist or orofacial pain specialist. For sounds originating from the ear or throat, an otolaryngologist (ENT) or a neurologist may be the appropriate specialist.
Diagnostic tools include a dental examination for teeth wear or a sleep study (polysomnography) to monitor jaw movement and muscle activity. The sleep study helps differentiate disorders and capture the sound’s timing. For suspected middle ear myoclonus, a doctor may examine the eardrum or use specialized tests.
Management strategies are tailored to the cause. For bruxism or TMJ dysfunction, a custom-fitted dental appliance or mouthguard stabilizes the joint. Stress reduction, physical therapy, and avoiding excessive gum chewing also provide relief. For palatal or middle ear myoclonus, medications such as muscle relaxants or anticonvulsants may be used to control involuntary muscle spasms.