Yatani Hirofumi, Studts Jamie, Cordova Matt, Carlson Charles R, Okeson Jeffrey P
Department of Oral and Maxillofacial Rehabilitation, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama 700-8525, Japan.
J Orofac Pain. 2002;16(3):221-8.
To explore the relationships between sleep quality, perceived pain, and psychologic distress among patients with temporomandibular disorders (TMD).
A total of 137 consecutive patients who sought care at the University of Kentucky Orofacial Pain Center for the management of TMD participated in this study and completed a battery of standardized, self-report questionnaires at their first clinic visit. The Pittsburgh Sleep Quality Index (PSQI) and the Multidimensional Pain Inventory (MPI) were used to measure patients' sleep quality and multiple dimensions of pain and suffering, respectively. The Revised Symptom Checklist-90 (SCL-90R) was used to evaluate psychologic symptoms. A median cutoff (PSQI total score: 10) divided the patients into 2 groups, i.e., 67 poor sleepers and 70 good sleepers.
There were no statistically significant differences in gender and age distributions between the 2 groups. Poor sleepers reported significantly higher scores than good sleepers on each of the 14 scales of the SCL-90R (P < .003) and on 7 of the 13 scales of the MPI (P < .05). Stepwise multiple regression analyses demonstrated that poorer sleep quality was predicted by higher pain severity (P < .001), greater psychologic distress (P < .05), and less perceived life control (P < .05).
This study supports the frequent comorbidity of reported sleep disturbance, perceived pain severity, and psychologic distress in patients with TMD.
探讨颞下颌关节紊乱病(TMD)患者的睡眠质量、疼痛感知与心理困扰之间的关系。
共有137名连续在肯塔基大学口腔颌面疼痛中心寻求TMD治疗的患者参与了本研究,并在首次门诊就诊时完成了一系列标准化的自我报告问卷。匹兹堡睡眠质量指数(PSQI)和多维疼痛量表(MPI)分别用于测量患者的睡眠质量以及疼痛和痛苦的多个维度。修订版症状自评量表90(SCL - 90R)用于评估心理症状。以中位数临界值(PSQI总分:10)将患者分为两组,即67名睡眠质量差的患者和70名睡眠质量好的患者。
两组之间在性别和年龄分布上无统计学显著差异。睡眠质量差的患者在SCL - 90R的14个量表中的每一个量表上的得分均显著高于睡眠质量好的患者(P < .003),在MPI的13个量表中的7个量表上也是如此(P < .05)。逐步多元回归分析表明,疼痛严重程度较高(P < .001)、心理困扰较大(P < .05)以及生活控制感较低(P < .05)可预测睡眠质量较差。
本研究支持TMD患者中报告的睡眠障碍、疼痛严重程度感知和心理困扰经常合并存在的观点。