J Oral Facial Pain Headache. 2021;35(1):41-53. doi: 10.11607/ofph.2780.
To investigate the associations between temporomandibular disorders (TMDs) and sleep disorders in adult subjects.
The PubMed, Embase, Evidence-Based Medicine Reviews, and ProQuest Dissertations & Theses databases were searched for studies published in English up to September 2019. Unpublished/gray literature and reference lists of identified articles were also examined. Inclusion criteria were male and female adults, presence or absence of a TMD based on the RDC/TMD or DC/TMD criteria, presence or absence of a sleep disorder according to the International Classification of Sleep Disorders, and any of the following study designs: cross-sectional, case-control, or longitudinal. Methodologic quality assessment was conducted using the National Heart, Lung, and Blood Institute quality assessment tools.
Twenty-two studies (11 cross-sectional, 9 case-control, 1 prospective cohort, and 1 mixed design) met the inclusion criteria. TMDs were assessed independently in relation to sleep bruxism (SB), obstructive sleep apnea (OSA), and sleep quality (SQ). All studies but one assessed TMDs using the RDC/TMD criteria. The relation between the TMD and the different sleep disorders was conflicting for SB and positive for OSA and SQ. Five studies were of good quality, and 17 were of fair quality.
The evidence is inconclusive regarding the relationship between TMDs and SB and insufficient regarding the relationship with OSA. There is consistently fair evidence to support an association between TMD and SQ. This study highlights the need for higher-quality longitudinal studies to clarify the association between TMDs and sleep disorders.
调查成人颞下颌关节紊乱（TMD）与睡眠障碍之间的关联。
检索了 PubMed、Embase、循证医学评价数据库和 ProQuest 学位论文与期刊全文数据库，检索时间截至 2019 年 9 月，检索语言为英文。同时还查阅了未发表的/灰色文献和已确定文章的参考文献列表。纳入标准为：男性和女性成年人，基于 RDC/TMD 或 DC/TMD 标准存在或不存在 TMD，根据国际睡眠障碍分类存在或不存在睡眠障碍，以及以下任何一种研究设计：横断面、病例对照或纵向研究。使用美国国立心肺血液研究所的质量评估工具进行方法学质量评估。
符合纳入标准的研究有 22 项（11 项横断面研究、9 项病例对照研究、1 项前瞻性队列研究和 1 项混合设计研究）。TMD 是独立于磨牙症（SB）、阻塞性睡眠呼吸暂停（OSA）和睡眠质量（SQ）来评估的。除了一项研究外，所有研究均使用 RDC/TMD 标准评估 TMD。TMD 与不同睡眠障碍之间的关系存在矛盾，SB 方面的关系不确定，OSA 和 SQ 方面的关系为阳性。5 项研究质量较好，17 项研究质量为中等。
关于 TMD 与 SB 之间的关系，证据尚无定论，关于与 OSA 的关系，证据不足。有充分证据表明 TMD 与 SQ 之间存在关联。本研究强调需要进行更高质量的纵向研究，以阐明 TMD 与睡眠障碍之间的关系。
