阻塞性睡眠呼吸暂停对颞下颌关节紊乱病患者疼痛敏化和下颌功能的潜在作用。
Potential Role of Obstructive Sleep Apnea on Pain Sensitization and Jaw Function in Temporomandibular Disorder Patients.
机构信息
Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea.
Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Korea.
出版信息
J Korean Med Sci. 2022 Oct 10;37(39):e307. doi: 10.3346/jkms.2022.37.e307.
BACKGROUND
The relationships between obstructive sleep apnea (OSA) and diverse types of pain disorders have been reported. However, the interaction between OSA and pain-related temporomandibular disorder (TMD) remains obscure.
METHODS
A total of 60 adults (male/female, 48/12; mean age, 41.7 ± 13.2 years) with pain-related TMD were enrolled. All participants underwent overnight full-channel polysomnography and had assessment of size and position of the tongue, tonsillar size, height, and weight. Diagnostic Criteria/TMD criteria was applied to diagnose TMD. Myofascial trigger points (TrPs) were bilaterally evaluated in the two masticatory and four cervical muscles including the temporalis, masseter, trapezius, sternocleidomastoid, occipitalis, and splenius capitis muscles. Participants were divided into three groups in accordance with their levels of OSA.
RESULTS
The significantly higher number of active TrPs were detected in participants with severe OSA. The number of active TrPs in the masticatory muscles significantly interacted with diverse types of apneic and arousal indices.
CONCLUSION
The myofascial pain modulating mechanisms and jaw function could have interactions with nocturnal hypoxia and sleep fragmentation in chronic pain-related TMD patients.
背景
阻塞性睡眠呼吸暂停（OSA）与多种类型的疼痛障碍之间的关系已有报道。然而，OSA 与与疼痛相关的颞下颌关节紊乱（TMD）之间的相互作用仍不清楚。
方法
共纳入 60 名患有与疼痛相关的 TMD 的成年人（男/女，48/12；平均年龄，41.7±13.2 岁）。所有参与者均接受了整夜全通道多导睡眠图检查，并评估了舌的大小和位置、扁桃体大小、高度和重量。应用 TMD 诊断标准诊断 TMD。在颞肌、咬肌、斜方肌、胸锁乳突肌、枕骨和头夹肌这两块咀嚼肌和四块颈肌中双侧评估肌筋膜触发点（TrPs）。根据 OSA 的严重程度，将参与者分为三组。
结果
在严重 OSA 患者中，检测到的活动性 TrPs 数量明显更多。咀嚼肌中的活动性 TrPs 数量与各种类型的呼吸暂停和觉醒指数显著相互作用。
结论
在慢性与疼痛相关的 TMD 患者中，肌筋膜疼痛调节机制和颌功能可能与夜间低氧和睡眠片段化相互作用。
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