The role of sleep dysfunction in temporomandibular onset and progression: A systematic review and meta‐analyses

Abstract

Background Painful temporomandibular (TM) disorders result in 4.3 billion dollars spent annually in the United States. The complex interplay of physiological processes in persistent pain and dysfunctional sleep has been established. Recently, dysfunctional sleep has been identified as a potential pathway to the onset of painful TM disorder. Objectives The aims were to (1) identify self‐report outcome measures (SROMs) of sleep quality that are clinimetrically sound in patients with painful TM disorders and (2) determine whether sleep dysfunction has any diagnostic or prognostic value for this population. Methods A systematic search following PRISMA guidelines was run in six databases: CINAHL, Dental, PsychALL, PubMed, Scopus and Web of Science. Any study involving minors was excluded. Risks of biases were examined in all studies. Diagnostic pooled findings were reported. Results Of the identified articles (n = 681), 18 were included in this systematic review (n = 1 clinimetric studies, n = 11 diagnostic studies, n = 6 prognostic studies). Nine different assessment tools were used; only the Pittsburg Sleep Quality Index (PSQI) has been validated in patients with painful TM disorders. Overall, sleep dysfunction was diagnostic for painful TM disorders. The pooled relative risk of sleep dysfunction was 1.71 (95% CI 1.30. 2.26). When PSQI scores were greater than 5/21, the unadjusted hazard ratio for development of painful TM disorders was reported to be 2.1. Conclusion At present, the only SROM that has diagnostic and prognostic value in evaluating and managing patients with painful TM disorders is the PSQI.

Associations between obstructive sleep apnea and painful temporomandibular disorder: a systematic review

“…Sleep disorders are among the well-known comorbidities of TMD, particularly painful TMDs 2 , 4 - 12 . Sleep quality deterioration and chronic pain seem to have a bi-directional association; however, the influences of poor sleep quality on chronic pain are greater than those of chronic pain on sleep quality.…”

Influência do polimorfismo do gene SCN9A no perfil somatossensorial mecânico e na modulação da dor

“…Por fim nosso estudo verificou que indivíduos com DTM apresentam uma pior qualidade do sono, o que é apoiado pela literatura (SMITH et al, 2009;LEI et al, 2015;RAPHAEL et al, 2015;SOMMER;ETTLIN, 2015;BURR et al, 2020). A pobre qualidade de sono, também, foi associada com a severidade da dor experimentada (QUARTANA et al, 2010).…”

“…Esse estudo reforça a indicação de que os profissionais de saúde devam rotineiramente implementar a avaliação da qualidade do sono, usando uma pontuação de corte de 5/21 no PSQI para rastrear a presença de disfunção do sono em pacientes com DTM dolorosa (BURR et al, 2020). Os resultados do nosso estudo verificaram uma mediana de 8 para o PSQI, o que corrobora os achados desta revisão sistemática.…”