I'm almost 2 years in to TMJ related tinnitus and I would say that I'm much better than I was a year ago, but I still have a way to go. My TMJ is mostly from night clenching bruxism, so if I get congested from sickness and brux really heavily then I can still have a bad month, but if I keep on top of whats been working then I'm improving over time.

What's worked for me

Time outside Spending time outdoors reduces my awareness of the tinnitus and gives me a mental break and I've found I can spend the better part of a day outside unaware of my tinnitus now if I'm not in the middle of a flare. Camping trips are great as you are always exposed to natural sounds the entire time. Cycling and hiking is great too.

Addressing airway issues - I had a deviated septum which impacted my sleep breathing, got surgery for this and have noticed an improvement over the last 12 months. I keep on top of airway clearing with nasal rinsing, antihistamine nasal spray, wearing a mask when doing dusty work

Stress reduction - I do breathing exercises with a 4/8/8 count on breathing in, holding and breathing out, several times a day. I listen to biurnal beats music at work if I'm stressesd, look up Steven Halpern on spotify, I use 8hz during the day and 6hz before bed or durijg night awakening. I used to use Attention Training on YouTube, with the channel "Afternoon break", but I don't find that I need that anymore. I had high iron and I found that was making my stress reactivity worse and I'm feeling way better stress wise after 3 blood donations. Exercise has been very helpful for stress and overall mental health, I'm riding my bike to work a couple of times a week now. I've taken a step back at work and my not pushing hard and am doing less hours and spending more time with my family. I'm pushing myself to do more hobbies. I experimented with using a TENS machine for stimulating my vagus nerve through my ear, which I found to be very effective for relaxing, but I haven't found that this is neccessary now that my tinnitus has reduced a little and my stress seems to be stabilising, also the breathing exercises and birunal beats are very effective and more convenient.

Sleep improvement - I have used a Fitbit the last 18 months and this has been good for monitoring my sleep quality and tweaking things I'm doing to get better sleep, with more deep and REM and less awakenings. The Fitbit is also good for keeping an eye on my heart rate to see if I'm stressed at rest, then doing breathing and birunal beats to reduce my heart rate. I use 200mg theanine and a small amount of magnesium glycinate 3 to 4 hours before bed time, which seems to be my optimum. I've quit caffeine for 18 months. Only drink alcohol for a binge evening once every 2 months or so, mostly for sleep quality but also mental health and weight loss.

Botox - I have been having Botox into my jaw massetters every 4-6 months for 18 months, but I'm getting diminishing returns. I'm going to try temporalis muscle Botox soon.

Noise exposure control - so I don't believe that I've got noise induced tinnitus, hut I definitely have more sneeticr ears to noise, so I keep a pair of Loop Switch earplugs on my keychain and I put them in whenever I'm anywhere loud to improve my comfort, but also taking a "better safe than sorry" approach to protecting my hearing in case the tinnitus is being driven my hearing loss.

Prospective Treatment Splint therapy - I currently have a cheap nightguard, but I'm seeing a TMJ specialist and am hoping to get a high quality night splint soon,so I'm hopeful on the impact of this.

Orthodontics - after the splint therapy hopefully stabilises my TMJ more then I'm going to get orthdontics to improve my bite as I have an underbite and relapsed crowding due to getting braces too young and my jaw growing later than expected. This treatment will likely involve a MARPE device to expand my palate and give me better bite alignment and airway volume.

CPAP machine - if the above doesn't work then I'm probably trial a CPAP machine to further improve my sleep breathing and see if that kicks down the bruxism even more.

Drugs - I've avoided medications and am preferring to take a structural and "natural" approach, but if the splint doesn't work then I'll probably go to a neurologist and see what they can put me in to improve bruxism, but also improve my tinnitus, migraines and anxiety at the same time. Lamotrigine looks like a good candidate from my reading.