J Oral Facial Pain Headache. 2023 Winter;37(1):47-53. doi: 10.11607/ofph.3269.
To determine sleep quality and associated factors in a group of patients with painful TMDs. The medical records of 80 patients with arthralgia and/or myofascial pain were reviewed and compared to a healthy control group. Data about sex, age, subjective pain, physical activity, social activity, subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI]), pain vigilance (Pain Vigilance and Awareness Questionnaire [PVAQ]), and pain catastrophizing (Pain Catastrophizing Scale [PCS]) were collected. Relationships between PSQI, age, pain intensity, PVAQ, and PCS in the TMD group were also analyzed. Data from the control group were used to transform the PSQI results into T-scores, which were then used to divide the TMD group into two subgroups: normal and impaired sleep. TMD patients presented a significantly higher ( < .001) PSQI score than the control group. Also, in the TMD group, there was a low to moderate correlation between PSQI and pain intensity and a significant correlation between PVAQ and PCS. The impaired sleep group presented a significantly higher ( < .001) PSQI T-score than the normal sleep group. Univariate analysis showed that subjective pain, social activity, and the PCS total and subscale scores differed significantly between the different PSQI T-score groups. The comparison between TMD pain patients and control subjects showed a significantly higher prevalence of T-score discordance in almost all PSQI components in TMD patients with impaired sleep. Subjective sleep quality in painful TMD patients could be associated with and influenced by psychosocial factors (catastrophizing and hypervigilance), social activity, and pain intensity.
确定一组患有疼痛性 TMD 患者的睡眠质量及其相关因素。
回顾性分析 80 例关节痛和/或肌筋膜痛患者的病历,并与健康对照组进行比较。收集性别、年龄、主观疼痛、身体活动、社会活动、主观睡眠质量(匹兹堡睡眠质量指数 [PSQI])、疼痛警觉(疼痛警觉和意识问卷 [PVAQ])和疼痛灾难化(疼痛灾难化量表 [PCS])的数据。还分析了 TMD 组中 PSQI、年龄、疼痛强度、PVAQ 和 PCS 之间的关系。使用对照组的数据将 PSQI 结果转换为 T 分数,然后将 TMD 组分为两组:正常睡眠组和睡眠障碍组。
与对照组相比,TMD 患者的 PSQI 评分明显更高(<0.001)。此外,在 TMD 组中,PSQI 与疼痛强度之间存在低至中度相关性,而 PVAQ 与 PCS 之间存在显著相关性。睡眠障碍组的 PSQI T 评分明显高于正常睡眠组(<0.001)。单因素分析显示,主观疼痛、社会活动以及 PCS 总分和各分量表评分在不同 PSQI T 评分组之间存在显著差异。与对照组相比,在睡眠障碍的 TMD 疼痛患者中,几乎所有 PSQI 成分的 T 评分差异均具有显著差异。
疼痛性 TMD 患者的主观睡眠质量可能与心理社会因素(灾难化和警觉)、社会活动和疼痛强度有关并受其影响。