Lee Yeon-Hee, Auh Q-Schick
Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Kyung Hee Medical center, Kyung Hee University, Seoul, Korea.
Dent Res Oral Health. 2022;5(4):83-93. doi: 10.26502/droh.0052. Epub 2022 Oct 7.
This study aimed to investigate portable polysomnography (PSG)-based 'sleep' and pre-diagnosis of obstructive sleep apnoea (OSA) in acute temporomandibular disorder (TMD) and patients with chronic TMD.
Randomly selected 25 patients with acute TMD (mean age, 42.58 ± 18.77 years; 14 females) and 26 age-and sex-matched patients with chronic TMD (mean age, 49.24 ± 17.52 years, 19 females) were enrolled.
The eight psychological subscales of SCL-90R had significantly higher values in the chronic TMD group than in the acute TMD group (all p < 0.05). There was no significant group difference in the respiratory event index examined using a portable PSG. OSA was observed in 57.7% in acute TMD, and 68.0% in chronic TMD, respectively. From the multiple regression analysis, palpation index was the strongest predictor of pre-diagnosis of OSA (OR = 17.550). Among the contributing factors for TMD, psychological stress (OR = 12.226), self-reported sleep problems (OR = 10.222), and above-average value of DEP (OR = 1.443) were followed.
Patients with chronic TMD were psychologically more vulnerable than those with acute TMD, and the existence of subjectively perceived sleep problems or objective sleep indices examined by portable PSG could affect TMD symptom severity in different ways.
本研究旨在调查基于便携式多导睡眠图(PSG)的急性颞下颌关节紊乱病(TMD)和慢性TMD患者的“睡眠”情况及阻塞性睡眠呼吸暂停(OSA)的预诊断。
随机选取25例急性TMD患者(平均年龄42.58±18.77岁;14例女性)和26例年龄及性别匹配的慢性TMD患者(平均年龄49.24±17.52岁,19例女性)。
慢性TMD组SCL-90R的8个心理分量表得分显著高于急性TMD组(均p<0.05)。使用便携式PSG检查的呼吸事件指数在两组间无显著差异。急性TMD患者中OSA的观察率为57.7%,慢性TMD患者中为68.0%。多元回归分析显示,触诊指数是OSA预诊断的最强预测因子(OR=17.550)。在TMD的影响因素中,心理压力(OR=12.226)、自我报告的睡眠问题(OR=10.222)以及抑郁量表(DEP)高于平均值(OR=1.443)依次排列。
慢性TMD患者在心理上比急性TMD患者更脆弱,主观感知的睡眠问题或便携式PSG检查的客观睡眠指标的存在可能以不同方式影响TMD症状的严重程度。