Although subjective sleep complaints have been associated with signs and symptoms of temporomandibular joint disorder (TMD), no study has evaluated the relation between objective sleep quality and TMD. The current study sough to evaluate the relation between objective sleep parameters, sleep disorders, and TMD. Forty-three participants (35 females, age = 29.6±10, BMI=25.48±5) underwent two noctural polysomnogram studies (PSG), had an RDC dental exam, and completed structured diagnostic interviews for sleep (SIS-D) and mental disorders (SCID). Eighty-eight percent of participants met criteria for a current sleep disorder (67% sleep bruxism; 37% insomnia (psychophysiologic = 8, secondary to TMD=3, idiopathic=3, due to mental d/o=2); 23.3% Obstructive Sleep Apnea (AHI: 5-15=6, 15.1 to 30=3, >30 =1); 4.7% periodic limb movement disorder; 2.3% restless legs syndrome; 2.3% nightmare disorder). Forty percent of the sample met criteria for two or more sleep disorders. Participants diagnosed with sleep disorders other than bruxism (n=20) reported increased fatigue, increased pain-related interference, and reduced assisted and unassisted mouth opening (all ps<.05). Minimum oxygen saturation was negatively associated with pain-related interference and fatigue. Sleep onset latency was negatively correlated with unassisted mouth opening, and wake after sleep onset time was positively correlated with fatigue. Sleep bruxism episodes/hour was associated with increased pain. These data indicate high rates of multiple sleep disorders in TMD patients. Further, it is notable that even despite young age, female sex, and relatively low BMI, the prevalence of sleep apnea rates was high in the current sample. Clinicians treating TMD patients should routinely assess sleep and consider referral for diagnostic evaluation of sleep disorders.
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© 2008 American Pain Society. Published by Elsevier Inc. All rights reserved.