Alessandri-Bonetti Anna, Sangalli Linda, Boggero Ian A
Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, KY 40536, United States.
Institute of Dental Clinic, A. Gemelli University Policlinic IRCCS, Catholic University of Sacred Heart, Rome 00168, Italy.
Pain Med. 2024 May 2;25(5):319-326. doi: 10.1093/pm/pnae003.
Few studies have investigated specific associations between insomnia and orofacial pain (OFP). The aim of this cross-sectional study was to examine relationships of insomnia with pain, mental health, and physical health variables among treatment-seeking patients with chronic OFP.
OFP diagnosis, demographics, insomnia symptoms, pain intensity, interference, and duration, mental health measures, and number of medical comorbidities were extracted from the medical records of 450 patients receiving an initial appointment at a university-affiliated tertiary OFP clinic. T-tests compared differences between patients with and without insomnia symptomatology, and between patients with different insomnia subtypes (delayed onset/early wakening).
Compared to patients without insomnia, those with elevated insomnia symptomatology (45.1%) reported higher pain intensity (60.70 ± 20.61 vs 44.15 ± 21.69; P < .001) and interference (43.81 ± 29.84 vs 18.40 ± 23.43; P < 0.001), depression/anxiety symptomatology (5.53 ± 3.32 vs 2.72 ± 2.66; P < 0.001), dissatisfaction with life (21.63 ± 6.95 vs 26.50 ± 6.21; P < .001), and number of medical comorbidities (6.72 ± 5.37 vs 4.37 ± 4.60; P < .001). Patients with Sleep Onset Latency insomnia (SOL-insomnia) (N = 76) reported higher pain intensity (t = 3.57; P < 0.001), and pain interference (t = 4.46; P < .001) compared to those without SOL-insomnia. Those with Early Morning Awakening insomnia (EMA-insomnia) (N = 71) did not significantly differ from those without EMA-insomnia on any of the variables. Differences remained significant after adjusting for age, sex, primary OFP diagnosis, and pain intensity.
Insomnia is associated with pain outcomes and should be appropriately managed when treating patients with chronic OFP.
很少有研究调查失眠与口面部疼痛（OFP）之间的具体关联。这项横断面研究的目的是检验慢性OFP求治患者中失眠与疼痛、心理健康和身体健康变量之间的关系。
从一所大学附属三级OFP诊所首次就诊的450例患者的病历中提取OFP诊断、人口统计学信息、失眠症状、疼痛强度、干扰情况、持续时间、心理健康指标以及合并症数量。采用t检验比较有无失眠症状的患者之间以及不同失眠亚型（入睡延迟/早醒）患者之间的差异。
与无失眠的患者相比，失眠症状严重的患者（45.1%）报告的疼痛强度更高（60.70±20.61对44.15±21.69；P<.001）、干扰情况更严重（43.81±29.84对18.40±23.43；P<0.001）、抑郁/焦虑症状更严重（5.53±3.32对2.72±2.66；P<.001）、生活满意度更低（21.63±6.95对26.50±6.21；P<.001）以及合并症数量更多（6.72±5.37对4.37±4.60；P<.001）。与无入睡延迟失眠（SOL-失眠）的患者相比，患有SOL-失眠的患者（N=76）报告的疼痛强度更高（t=3.57；P<0.001）以及疼痛干扰更严重（t=4.46；P<.001）。患有早醒失眠（EMA-失眠）的患者（N=71）在任何变量上与无EMA-失眠的患者相比均无显著差异。在对年龄、性别、原发性OFP诊断和疼痛强度进行校正后，差异仍然显著。
失眠与疼痛结局相关，在治疗慢性OFP患者时应予以适当处理。
