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Sleep Quality of Patients with Temporomandibular Disorders: Relationship to Clinical and Psychological Characteristics

  • Song, Kyung-Won (Department of Advanced General Dentistry, Dankook University Dental Hospital) ;
  • Kim, Mee-Eun (Department of Oral Medicine, College of Dentistry, Dankook University)
  • Received : 2015.11.02
  • Accepted : 2015.12.08
  • Published : 2015.12.30

Abstract

Purpose: The association between pain and sleep is described as a vicious cycle and psychological distress is well known as comorbid condition in the patients with pain and sleep problems. The aim of the study was to evaluate the prevalence of self-reported sleep disturbance and its relationship to clinical and psychological profiles in temporomandibular disorder (TMD) patients. Methods: The sample consisted of 123 TMD patients (90 women and 33 men), with a mean age of $39.9{\pm}15.4years$. Self-report measures of sleep quality, pain and psychological profile were conducted via the Pittsburgh Sleep Quality Index (PSQI), the Brief Pain Inventory and the Symptom Checklist-90-Revision at the initial visit. The primary diagnosis of TMD were categorized as TMD with internal derangement without pain, TMD with joint pain, TMD with muscle pain and TMD with joint-muscle combined pain. The chi-square test, independent t-test, oneway ANOVA and multiple linear regression analysis were used for statistics. Results: The patients was grouped as good sleepers (n=32, scores of 5 and lower) and poor sleepers (n=91, scores of 6 and higher) according to the recommended cutoff point of the global PSQI score (>5). TMD patients with pain showed poor sleep quality than TMD patients with internal derangement without pain. Poor sleepers had high pain interference and elevated psychological distress. Among them, pain interference and depression were significant predictors to sleep quality. Conclusions: The results suggest that sleep disturbance is a prevalent complaint in TMD patients, and sleep problems in TMD patients are associated with pain and psychological distress.

Keywords

Psychological;Sleep;Temporomandibular joint disorders

References

  1. Wu G, Chen L, Wei G, et al. Effects of sleep deprivation on painrelated factors in the temporomandibular joint. J Surg Res 2014;192:103-111. https://doi.org/10.1016/j.jss.2014.05.035
  2. Edwards RR, Grace E, Peterson S, Klick B, Haythornthwaite JA, Smith MT. Sleep continuity and architecture: associations with pain-inhibitory processes in patients with temporomandibular joint disorder. Eur J Pain 2009;13:1043-1047. https://doi.org/10.1016/j.ejpain.2008.12.007
  3. Smith MT, Wickwire EM, Grace EG, et al. Sleep disorders and their association with laboratory pain sensitivity in temporomandibular joint disorder. Sleep 2009;32:779-790. https://doi.org/10.1093/sleep/32.6.779
  4. Benoliel R, Eliav E, Sharav Y. Self-reports of pain-related awakenings in persistent orofacial pain patients. J Orofac Pain 2009;23:330-338.
  5. Lavigne G, Zucconi M, Castronovo C, Manzini C, Marchettini P, Smirne S. Sleep arousal response to experimental thermal stimulation during sleep in human subjects free of pain and sleep problems. Pain 2000;84:283-290. https://doi.org/10.1016/S0304-3959(99)00213-4
  6. Nicassio PM, Moxham EG, Schuman CE, Gevirtz RN. The contribution of pain, reported sleep quality, and depressive symptoms to fatigue in fibromyalgia. Pain 2002;100:271-279. https://doi.org/10.1016/S0304-3959(02)00300-7
  7. Menefee LA, Cohen MJ, Anderson WR, Doghramji K, Frank ED, Lee H. Sleep disturbance and nonmalignant chronic pain: a comprehensive review of the literature. Pain Med 2000;1:156-172. https://doi.org/10.1046/j.1526-4637.2000.00022.x
  8. Shaver JL, Lentz M, Landis CA, Heitkemper MM, Buchwald DS, Woods NF. Sleep, psychological distress, and stress arousal in women with fibromyalgia. Res Nurs Health 1997;20:247-257. https://doi.org/10.1002/(SICI)1098-240X(199706)20:3<247::AID-NUR7>3.0.CO;2-I
  9. Smith MT, Perlis ML, Smith MS, Giles DE, Carmody TP. Sleep quality and presleep arousal in chronic pain. J Behav Med 2000;23:1-13. https://doi.org/10.1023/A:1005444719169
  10. Ohayon MM. Relationship between chronic painful physical condition and insomnia. J Psychiatr Res 2005;39:151-159. https://doi.org/10.1016/j.jpsychires.2004.07.001
  11. Riley JL 3rd, Benson MB, Gremillion HA, et al. Sleep disturbance in orofacial pain patients: pain-related or emotional distress? Cranio 2001;19:106-113. https://doi.org/10.1080/08869634.2001.11746159
  12. Rugh JD, Woods BJ, Dahlstrom L. Temporomandibular disorders: assessment of psychological factors. Adv Dent Res 1993;7:127-136. https://doi.org/10.1177/08959374930070020301
  13. Oakley ME, McCreary CP, Flack VF, Clark GT. Screening for psychological problems in temporomandibular disorder patients. J Orofac Pain 1993;7:143-149.
  14. Kim MJ, Lim MJ, Park WK, Kho HS. Comparison between the SCL-90-R and MMPI in TMD patients with psychological problems. Oral Dis 2012;18:140-146. https://doi.org/10.1111/j.1601-0825.2011.01854.x
  15. Von Korff M, Simon G. The relationship between pain and depression. Br J Psychiatry Suppl 1996;(30):101-108.
  16. Yatani H, Studts J, Cordova M, Carlson CR, Okeson JP. Comparison of sleep quality and clinical and psychologic characteristics in patients with temporomandibular disorders. J Orofac Pain 2002;16:221-228.
  17. Lautenbacher S. Pain, sleeping problems and their many relatives. Pain 2012;153:1138. https://doi.org/10.1016/j.pain.2012.03.001
  18. Naughton F, Ashworth P, Skevington SM. Does sleep quality predict pain-related disability in chronic pain patients? The mediating roles of depression and pain severity. Pain 2007;127:243-252. https://doi.org/10.1016/j.pain.2006.08.019
  19. Nicassio PM, Ormseth SR, Kay M, et al. The contribution of pain and depression to self-reported sleep disturbance in patients with rheumatoid arthritis. Pain 2012;153:107-112. https://doi.org/10.1016/j.pain.2011.09.024
  20. Campbell P, Tang N, McBeth J, et al. The role of sleep problems in the development of depression in those with persistent pain: a prospective cohort study. Sleep 2013;36:1693-1698. https://doi.org/10.5665/sleep.3130
  21. Emery PC, Wilson KG, Kowal J. Major depressive disorder and sleep disturbance in patients with chronic pain. Pain Res Manag 2014;19:35-41. https://doi.org/10.1155/2014/480859
  22. Bigatti SM, Hernandez AM, Cronan TA, Rand KL. Sleep disturbances in fibromyalgia syndrome: relationship to pain and depression. Arthritis Rheum 2008;59:961-967. https://doi.org/10.1002/art.23828
  23. Sener S, Guler O. Self-reported data on sleep quality and psychologic characteristics in patients with myofascial pain and disc displacement versus asymptomatic controls. Int J Prosthodont 2012;25:348-352.
  24. Rener-Sitar K, John MT, Bandyopadhyay D, Howell MJ, Schiffman EL. Exploration of dimensionality and psychometric properties of the Pittsburgh Sleep Quality Index in cases with temporomandibular disorders. Health Qual Life Outcomes 2014;12:10. https://doi.org/10.1186/1477-7525-12-10
  25. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213. https://doi.org/10.1016/0165-1781(89)90047-4
  26. Derogatis LR, Lipman RS, Covi L. SCL-90: an outpatient psychiatric rating scale--preliminary report. Psychopharmacol Bull 1973;9:13-28.
  27. Derogatis LR, Rickels K, Rock AF. The SCL-90 and the MMPI: a step in the validation of a new self-report scale. Br J Psychiatry 1976;128:280-289. https://doi.org/10.1192/bjp.128.3.280
  28. Kim KI, Kim JH, Won HT. Korean manual of symptom Checklist-90-Revision. Seoul: Chungang Attitude Publishing Co.; 1984. pp. 7-37.
  29. Radbruch L, Loick G, Kiencke P, et al. Validation of the German version of the Brief Pain Inventory. J Pain Symptom Manage 1999;18:180-187. https://doi.org/10.1016/S0885-3924(99)00064-0
  30. Smith MT, Haythornthwaite JA. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev 2004;8:119-132. https://doi.org/10.1016/S1087-0792(03)00044-3
  31. Call-Schmidt TA, Richardson SJ. Prevalence of sleep disturbance and its relationship to pain in adults with chronic pain. Pain Manag Nurs 2003;4:124-133. https://doi.org/10.1016/S1524-9042(02)54212-0
  32. Wilson KG, Eriksson MY, D'Eon JL, Mikail SF, Emery PC. Major depression and insomnia in chronic pain. Clin J Pain 2002;18:77-83. https://doi.org/10.1097/00002508-200203000-00002
  33. Wilson KG, Watson ST, Currie SR. Daily diary and ambulatory activity monitoring of sleep in patients with insomnia associated with chronic musculoskeletal pain. Pain 1998;75:75-84. https://doi.org/10.1016/S0304-3959(97)00207-8
  34. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000;85:317-332. https://doi.org/10.1016/S0304-3959(99)00242-0
  35. Nicassio PM, Wallston KA. Longitudinal relationships among pain, sleep problems, and depression in rheumatoid arthritis. J Abnorm Psychol 1992;101:514-520. https://doi.org/10.1037/0021-843X.101.3.514
  36. Smith GR. The epidemiology and treatment of depression when it coexists with somatoform disorders, somatization, or pain. Gen Hosp Psychiatry 1992;14:265-272. https://doi.org/10.1016/0163-8343(92)90097-T
  37. Affleck G, Urrows S, Tennen H, Higgins P, Abeles M. Sequential daily relations of sleep, pain intensity, and attention to pain among women with fibromyalgia. Pain 1996;68:363-368. https://doi.org/10.1016/S0304-3959(96)03226-5