Subjective Sleep Quality Deteriorates Before Development of Painful Temporomandibular Disorder

JOURNAL OF PAIN

卷:17

Article

Sanders, Anne E.¹  Akinkugbe, Aderonke A.²  Bair, Eric^3,4,5  Fillingim, Roger B.⁶  Greenspan, Joel D.⁷  Ohrbach, Richard⁸  Dubner, Ronald⁹  Maixner, William^4,5  Slade, Gary D.^1,5 

[1] Univ N Carolina, Dept Dent Ecol, Chapel Hill, NC USA

[2] Univ N Carolina, Dept Epidemiol, Chapel Hill, NC USA

[3] Univ N Carolina, Dept Biostat, Chapel Hill, NC USA

[4] Univ N Carolina, Dept Endodont, Chapel Hill, NC USA

[5] Univ N Carolina, Ctr Pain Res & Innovat, Chapel Hill, NC USA

[6] Univ Florida, Pain Res & Intervent Ctr Excellence, Gainesville, FL USA

[7] Univ Maryland, Sch Dent, Dept Neural & Pain Sci, Baltimore, MD 21201 USA

[8] Univ Maryland, Sch Dent, Brotman Facial Pain Clin, Baltimore, MD 21201 USA

[9] Univ Buffalo, Dept Oral Diagnost Sci, Buffalo, NY USA

关键词: Epidemiology;    musculoskeletal pain;    pain perception;    psychological stress;    sleep quality;   

DOI  :  10.1016/j.jpain.2016.02.004

来源: Elsevier

【 摘 要 】

There is good evidence that poor sleep quality increases risk of painful temporomandibular disorder (TMD). However, little is known about the course of sleep quality in the months preceding TMD onset, and whether the relationship is mediated by heightened sensitivity to pain. The Pittsburgh Sleep Quality Index was administered at enrollment into the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) prospective cohort study. Thereafter the Sleep Quality Numeric Rating Scale was administered every 3 months to 2,453 participants. Sensitivity to experimental pressure pain and pinprick pain stimuli was measured at baseline and repeated during follow-up of incident TMD cases (n = 220) and matched TMD-free controls (n = 193). Subjective sleep quality deteriorated progressively, but only in those who subsequently developed TMD. A Cox proportional hazards model showed that risk of TMD was greater among participants whose sleep quality worsened during follow-up (adjusted hazard ratio = 1.73, 95% confidence limits = 1.29, 2.32). This association was independent of baseline measures of sleep quality, psychological stress, somatic awareness, comorbid conditions, nonpain facial symptoms, and demographic characteristics. Poor baseline sleep quality was not significantly associated with baseline pain sensitivity or with subsequent change in pain sensitivity. Furthermore the relationship between sleep quality and TMD incidence was not mediated via baseline pain sensitivity or change in pain sensitivity. Perspective: Subjective sleep quality deteriorates progressively before the onset of painful TMD, but sensitivity to experimental pain does not mediate this relationship. Furthermore, the relationship is independent of potential confounders such as psychological stress, somatic awareness, comorbid conditions, nonpain facial symptoms, and various demographic factors. (C) 2016 by the American Pain Society

【 授权许可】

Free