Association Between Sleep Quality and Temporomandibular Disorders (TMD) Symptoms Among Adults: A Cross-Sectional Study.

BACKGROUND

Temporomandibular disorders (TMDs) are a cluster of musculoskeletal and functional disorders of the jaw joint and associated muscles, frequently associated with pain, stress, and decreased quality of life. More recent literature emphasizes a strong correlation between symptoms of TMD and poor sleep quality, but the literature is limited in diverse adult populations. This study explores the interaction between sleep quality and TMD symptoms, as well as the demographic variables of age, gender, and marital status.

METHODS

We enrolled 385 adults in this cross-sectional study from both general and dental outpatient departments in Islamabad, Pakistan. To assess TMD symptoms, we used the Fonseca Anamnestic Index (FAI), and we measured sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Data collection was conducted between February 2025 and April 2025. Data were analyzed using IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp., including descriptive statistics, Spearman correlation, Mann-Whitney U tests, Kruskal-Wallis H tests, and ordinal logistic regression.

RESULTS

The total sample (N = 385) consisted of 182 men (47%), 150 women (39%), and 53 participants (14%) who did not wish to have their gender revealed. The largest age group was 18-25 years (N = 275; 71%). There was a strong positive association between PSQI and FAI scores (r = 0.223, p-value < 0.001), indicating that lower sleep quality was associated with more severe TMD symptoms. Participants who were not taking medication (N = 106, 28%) reported worse scores than those taking medication (N = 279, 72%). The regression analysis indicated that TMD severity was substantially predicted by PSQI scores (B = 0.119, p-value < 0.001).

CONCLUSION

This research highlights a significant association between poor sleep quality and heightened TMD symptom severity in adults. Demographic variables, such as age, gender, and marital status, also influenced these results. These results suggest the utility of sleep evaluation in diagnosing TMD and the development of multidisciplinary treatment protocols. The use of a longitudinal research design that incorporates objective sleep assessment and psychological measures is recommended for future studies to examine causal pathways.