Associations of self-report and actigraphy sleep measures with experimental pain outcomes in patients with temporomandibular disorder and healthy controls

Boggero, Ian A.; Schneider, Victor J.; Thomas, Priya L.; Nahman‐Averbuch, Hadas; King, Christopher D.

doi:10.1016/j.jpsychores.2019.05.008

Cited by 11 publications

(14 citation statements)

References 18 publications

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“…Self-reported and objective sleep measures seem to be differentially related to pain. [9][10][11][12] Self-report measures generally yield larger group differences than actigraphy and PSG measures in case-controlled chronic pain studies, and may be more strongly associated with reported levels of pain in experimental studies. 9,13 Polysomnography (PSG) is considered the gold standard of objective sleep recording, enabling assessment of both sleep continuity and sleep architecture, as well as detection of abnormal sleep related respiration and movement.…”

Section: Introductionmentioning

confidence: 99%

“…13,15 Among controlled actigraphy studies, several do not observe group differences in sleep continuity measures. 9,16,17 Others report Sleep disturbance in chronic musculoskeletal pain group differences, most consistently for WASO and SE. [18][19][20] In addition to differentiating groups, SE and WASO have been associated with reported pain, 18,21 and SE was related to pain inhibition in an experimental study among pain patients.…”

Section: Introductionmentioning

confidence: 99%

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Sleep Characteristics in Adults With and Without Chronic Musculoskeletal Pain

Abeler

Friborg

Engstrøm

et al. 2020

The Clinical Journal of Pain

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Objectives: Sleep disturbance is associated with persistence and exacerbation of chronic pain. As this relationship seems to be bidirectional, factors underpinning sleep disturbance may prove valuable in multimodal rehabilitation approaches. The aim of this cross-sectional study was to examine the impact of psychological symptoms on subjective and objective sleep measures in patients with chronic musculoskeletal pain (CMP) as compared to healthy controls (HC). Methods: Sleep was assessed by self-report questionnaires, actigraphy and polysomnography recordings in 56 patients (75.0% female; Mage = 41.7 years, SD = 10.8 years) with CMP and compared to 53 matched HC (71.7% female; Mage = 41.8 years, SD = 10.7). Mental distress (HSCL) and pain catastrophizing (PCS) were tested as predictors of objective and subjective sleep measures in multiple regression models, and their indirect effects were tested in bootstrapped mediation models.Results: The sleep data revealed substantially more subjective sleep disturbance (Hedge's g: 1.32-1.47, p < .001), moderately worse sleep efficiency in the actigraphy measures (Hedges g: 0.5-0.6, p < .01) and less polysomnography measured slow wave sleep (SWS) (Hedges g: 0.43, p < .05) in patients as compared to controls. HSCL was strongly associated with the self-reported measures Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI). HSCL also partially explained the pain (CMP / HC) to sleep association, but HSCL was not associated with any of the objective sleep measures. More pain catastrophizing was related to less SWS. Discussion: The differences in subjective and objective sleep measures indicate that they probe different aspects of sleep functioning in patients with musculoskeletal pain, and their combined application may be valuable in clinical practice. Self-reported sleep disturbance seems to overlap with affective dimensions reflected by the HSCL-questionnaire.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sleep Characteristics in Adults With and Without Chronic Musculoskeletal Pain

Abeler

Friborg

Engstrøm

et al. 2020

The Clinical Journal of Pain

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“…After informed consent and health history review, all participants underwent a standardized clinical examination (DC-TMD) by a calibrated investigator for TMD. 5 , 34 In participants with TMD (n = 19) and pain-free healthy controls (HCs, n = 17), a blood sample was collected for gene expression profiling (Fig. 1 A).…”

Section: Methodsmentioning

confidence: 99%

Preliminary evidence for conserved transcriptional response to adversity in adults with temporomandibular disorder

King¹,

Boggero²,

Schulert³

et al. 2021

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Introduction: Temporomandibular disorder (TMD) is one of the most common orofacial pain conditions. Alteration in immune functioning is one promising biological mechanism underlying pain in TMD. However, there is a gap in the understanding of molecular bases contributing to altered immune functioning in these patients. Objectives: In the current study, we investigated whether individuals with TMD would exhibit differential activity of 3 specific transcription factors involved in inflammatory (nuclear factor-kappa B, NF-kB), antiviral (interferon-regulatory factors, IRF), and sympathetic (cAMP response element-binding protein, CREB) processes using a promoter-based bioinformatics analysis, which is characterized as the “Conserved Transcriptional Response to Adversity.” Methods: Adults with TMD (n = 19) and without (n = 17) underwent a standardized clinical examination for TMD. A blood sample was collected for genome-wide transcriptional RNA profiling. Bioinformatic analyses tested for differential prevalence of proinflammatory and antiviral transcription factor activity in core promoter sequences from all genes showing >1.2-fold differential expression in TMD vs controls. Results: Promoter-based bioinformatic analyses of genome-wide transcriptome profiles confirmed upregulation of genes bearing response elements for proinflammatory transcription factor (NF-kB, P = 0.002) and downregulation of genes with response elements for IRF (P = 0.037) in patients with TMD relative to controls. Results also indicated upregulated activity of CREB in patients with TMD (P = 0.08), consistent with increased activity of the sympathetic nervous system. Conclusion: These results provide initial support that the regulation of immune pathways is altered in individuals with TMD. A shift of transcriptional resources to a proinflammatory state may be driven by psychosocial stress and contributes to symptoms associated with TMD.

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“…This manuscript includes data from eight different studies including unpublished studies, involving psychological and experimental pain outcome parameters [7,8,54,57]. For psychological measures, we focused on anxiety, depression and pain catastrophizing.…”

Section: Methodsmentioning

confidence: 99%

Relationships between Psychological Factors and Experimental Pain Outcomes in Healthy Individuals: Results from 8 Studies

Nahman‐Averbuch¹,

Ia²,

Bm³

et al. 2021

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Psychological factors, such as anxiety, depression, and pain catastrophizing, may affect how healthy individuals experience experimental pain. However, current literature puts forth contradictory results, possibly due to differing study methodologies, such as the type of psychophysical measure or survey. To better understand such results, this paper analyzed the relationships between psychological factors and experimental pain outcomes across eight different studies (total n= 595) conducted in different populations of healthy adult and adolescent participants. Analyses were conducted with and without controlling for sex, age, and race. Each study was analyzed separately and as part of an aggregate analysis. Even without correction for multiple comparisons, only a few significant relationships were found for the individual studies. Controlling for demographic factors had minimal effect on the results. Importantly, even the few statistically significant models showed relatively small effect sizes; psychological factors explained no more than 20% of the variability in experimental pain sensitivity of healthy individuals. The aggregate analyses revealed relationships between anxiety and PPT / cold pain ratings and between pain catastrophizing and PPT. Sample size calculations based on the aggregate analyses indicated that several hundred participants would be required to correctly detect relationships between these psychological factors and pain measures. These overall negative findings suggest that anxiety, depression, and pain catastrophizing in healthy individuals may not be meaningfully related to experimental pain outcomes. Furthermore, positive findings in the literature may be subject to small group effects and publication bias towards positive findings.

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Associations of self-report and actigraphy sleep measures with experimental pain outcomes in patients with temporomandibular disorder and healthy controls

Cited by 11 publications

References 18 publications

Sleep Characteristics in Adults With and Without Chronic Musculoskeletal Pain

Sleep Characteristics in Adults With and Without Chronic Musculoskeletal Pain

Preliminary evidence for conserved transcriptional response to adversity in adults with temporomandibular disorder

Relationships between Psychological Factors and Experimental Pain Outcomes in Healthy Individuals: Results from 8 Studies

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