Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21224, United States.
Department of Advanced Oral Sciences and Therapeutics, University of Maryland Baltimore, School of Dentistry, Baltimore, MD 21201, United States.
Pain Med. 2024 Jul 1;25(7):434-443. doi: 10.1093/pm/pnae022.
Patients with chronic pain disorders, including Temporomandibular Disorders (TMDs) endorse high levels of sleep disturbances, frequently reporting reduced sleep quality. Despite this, little is known about the effect that daytime pain has on the microstructure and macro-architecture of sleep. Therefore, we aimed to examine the extent to which daytime pain sensitivity, measured using quantitative sensory testing (QST), is associated with objective sleep parameters the following night, including sleep architecture and power spectral density, in women with TMD.
144 females with myalgia and arthralgia by examination using the Diagnostic criteria for TMD completed a comprehensive QST battery consisting of General Pain Sensitivity, Central Sensitization Index, and Masseter Pressure Pain Threshold assessments. Polysomnography was collected the same night to measure sleep architecture and calculate relative power in delta, theta, alpha, sigma, and beta power bands.
Central Sensitization (B = -3.069, P = .009), General Pain Sensitivity Indices (B = -3.069, P = .007), and Masseter Pain Pressure Threshold (B = 0.030, P = .008) were significantly associated with lower REM% both before and after controlling for covariates. Pain sensitivity measures were not significantly associated with relative power in any of the spectral bands nor with any other sleep architectural stages.
Our findings demonstrate that higher generalized pain sensitivity, masseter pain pressure threshold, as well as central sensitization were associated with a lower percentage of REM in participants with myofascial pain and arthralgia of the masticatory system. These findings provide an important step toward understanding the mechanistic underpinnings of how chronic pain interacts with sleep physiology.
包括颞下颌关节紊乱症（TMD）在内的慢性疼痛障碍患者报告睡眠质量差，睡眠障碍程度较高。尽管如此，对于日间疼痛对睡眠微观结构和宏观结构的影响知之甚少。因此，我们旨在研究 TMD 女性中，使用定量感觉测试（QST）测量的日间疼痛敏感性与次日夜间的客观睡眠参数（包括睡眠结构和功率谱密度）之间的关联程度。
144 名通过 TMD 诊断标准检查确诊为肌痛和关节痛的女性接受了全面的 QST 测试，包括一般疼痛敏感性、中枢敏化指数和咀嚼肌压痛阈值评估。同一天晚上进行多导睡眠图检查，以测量睡眠结构并计算 delta、theta、alpha、sigma 和 beta 频段的相对功率。
中枢敏化（B=-3.069，P=0.009）、一般疼痛敏感性指数（B=-3.069，P=0.007）和咀嚼肌压痛阈值（B=0.030，P=0.008）与 REM%均呈显著负相关，在控制协变量后仍然如此。疼痛敏感性测量与任何频谱带的相对功率或任何其他睡眠结构阶段均无显著相关性。
我们的研究结果表明，广泛性疼痛敏感性、咀嚼肌压痛阈值以及中枢敏化程度较高与咀嚼肌系统的肌筋膜疼痛和关节痛患者 REM 百分比降低有关。这些发现为理解慢性疼痛与睡眠生理相互作用的机制基础提供了重要步骤。
