University at Buffalo - The State University of New York
Skip to Content
Subjective Sleep Quality Deteriorates Before Development of Painful Temporomandibular Disorder. - PubMed - NCBI
Format

Send to

Choose Destination
See comment in PubMed Commons below
J Pain. 2016 Jun;17(6):669-77. doi: 10.1016/j.jpain.2016.02.004. Epub 2016 Feb 21.

Subjective Sleep Quality Deteriorates Before Development of Painful Temporomandibular Disorder.

Author information

1
Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: anne_sanders@unc.edu.
2
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
3
Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Pain Research and Innovation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
4
Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida.
5
Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, Maryland; Brotman Facial Pain Clinic, University of Maryland School of Dentistry, Baltimore, Maryland.
6
Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York.
7
Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, Maryland.
8
Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Pain Research and Innovation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
9
Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Pain Research and Innovation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Abstract

There is good evidence that poor sleep quality increases risk of painful temporomandibular disorder (TMD). However, little is known about the course of sleep quality in the months preceding TMD onset, and whether the relationship is mediated by heightened sensitivity to pain. The Pittsburgh Sleep Quality Index was administered at enrollment into the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) prospective cohort study. Thereafter the Sleep Quality Numeric Rating Scale was administered every 3 months to 2,453 participants. Sensitivity to experimental pressure pain and pinprick pain stimuli was measured at baseline and repeated during follow-up of incident TMD cases (n = 220) and matched TMD-free controls (n = 193). Subjective sleep quality deteriorated progressively, but only in those who subsequently developed TMD. A Cox proportional hazards model showed that risk of TMD was greater among participants whose sleep quality worsened during follow-up (adjusted hazard ratio = 1.73, 95% confidence limits = 1.29, 2.32). This association was independent of baseline measures of sleep quality, psychological stress, somatic awareness, comorbid conditions, nonpain facial symptoms, and demographic characteristics. Poor baseline sleep quality was not significantly associated with baseline pain sensitivity or with subsequent change in pain sensitivity. Furthermore the relationship between sleep quality and TMD incidence was not mediated via baseline pain sensitivity or change in pain sensitivity.

PERSPECTIVE:

Subjective sleep quality deteriorates progressively before the onset of painful TMD, but sensitivity to experimental pain does not mediate this relationship. Furthermore, the relationship is independent of potential confounders such as psychological stress, somatic awareness, comorbid conditions, nonpain facial symptoms, and various demographic factors.

KEYWORDS:

Epidemiology; musculoskeletal pain; pain perception; psychological stress; sleep quality

PMID:
26902644
PMCID:
PMC4885773
DOI:
10.1016/j.jpain.2016.02.004
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center