I've also suffered from TMJD fatigue - to the point where getting out of bed to go to the washroom felt like climbing Everest! I'm so sorry you are experiencing fatigue - especially hard when you have to perform important tasks like finals...
Fatigue is a complex thing with no easy answers or quick fixes for me. Some things definitely helped so I'll share those with you in the hopes that something may also work for you.
1) I saw an excellent naturopath/Dr. of Chinese Medicine (he's qualified for both). See someone well reputed. My whole system was really taxed, adrenals shot etc, and someone in this area can really help in a way that western doctors can't (they might just offer antidepressants!)
2) Diet – if you are on a soft food or liquid diet (or regular food diet, student diet?) you may not be getting adequate nutrition and this can contribute to fatigue.
3) Posture – poor alignment really contributes to TMJD. If you are a student, you may be hunched over books a lot and this could be worsening your situation. I saw an excellent TMJ physio who really helped me. For me, staying in a correct postural alignment is really important in keeping out of pain and fatigue. The physio also guided me toward relaxing the muscles through application of moist heat (dry heat is less effective), jaw exercises and diaphragmatic breathing. All this helps loosen up tight muscles that contribute to pain and fatigue.
4) Night clenching:
- Definitely work on your night clenching so you can get a replenishing night’s sleep. One way to do this is through muscle relaxants (try till you find one that works and doesn't make you feel horrible the next morning - you can research this site for suggestions). I see this as a short term solution though.
- You can try hypnotism as well. I saw a bad hypnotist who didn't help and then a good one who really did. He made a recording for me that I listen to right before drifting off and that really helps too.
- One of the theories about TMJ night clenching is that it can be caused by the unstable jaw desperately trying to seek a comfortable position at night. My experience has shown me that there may be some truth to this. As soon as my jaw started to find comfort in my stage one, splint therapy, – about 5 months in – clenching vastly improved. Likewise, as soon as the splint was removed for the 2 weeks before braces, I started clenching madly again. Have you started to solve the problems in your jaw? Once you do, this may help. (By the way, my night guard made my clenching worse!)
- I’ve read that swimmers nose plugs can help as they force you to breath your mouth, making clenching near impossible. Haven't tried this one yet, but it's on the list! I think I'm a bit freaked out!
- Decrease anxiety in general and before bed. Try Mindfulness Based Stress Reduction (MBSR) You can take the course and or just read the book it's based on - "Full Catastrophe Living" by Jon Kabat-Zinn. Extremely helpful in dealing with pain and anxiety. Best tool I've come across so far.
Just a few ideas to think about. Best of luck in your finals – I hope you find some things to help improve your situation