Subjective sleep complaints were associated with painful temporomandibular disorders in adolescents: The Epidor‐Adolescere study

• Published in: Journal of oral rehabilitation Vol. 49; no. 9; pp. 849 - 859
• Main Authors: Fernandes, Giovana, Selms, Maurits K. A., Lobbezoo, Frank, Aarab, Ghizlane, Braido, Guilherme Vinícius Vale, Campi, Leticia Bueno, Jordani, Paula Cristina, Gonçalves, Daniela Aparecida Godoi
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-09-2022
• Subjects: adolescent; Adolescents; association; facial pain; Pain; Sleep; sleep quality; sleep–wake disorder initiation; Teenagers; temporomandibular disorders; Temporomandibular joint disorders; Association; Facial Pain; Sleep Quality; Sleep Wake Disorder Initiation; Adolescent; Temporomandibular Disorders
• DOI: 10.1111/joor.13344
• EISSN: 1365-2842
• ISSN: 0305-182X

Background
Sleep disturbances in adolescents has received a lot of attention in the literature and it is recognised as a serious health concern. The association between pain and sleep disturbances in adolescents has been extensively studied. However, to the best of our knowledge, there is a lack of studies investigating the association between various subjective sleep variables and painful TMD in adolescents.
Objectives
to investigate the association between painful TMD and subjective sleep variables in adolescents' non‐clinical sample. We conducted a cross‐sectional study. TMD was classified according to the RDC/TMD criteria. The Revised Face Scale evaluated TMD pain intensity, and pressure pain thresholds (PPTs) were assessed in trigeminal and extra‐trigeminal areas. The subjective sleep variables were assessed according to the Sleep Disturbance Scale for Children and Sleep Behaviour Questionnaire.
Results
The final sample consisted of 690 adolescents (12.7 ± 0.76 years), with 16.2% of them presenting painful TMD. Adolescents who frequently reported waking up more than twice per night and feeling tired when awake were more likely to present painful TMD symptoms [OR = 1.7 (95% CI: 1.04–2.90); p = .034 and OR = 1.6 (95% CI: 1.01–2.48); p = .046, respectively]. The intensity of TMD pain was negatively associated with sleep quality (p = .015). Also, PPT values in the trigeminal and extra‐trigeminal areas were negatively associated with total sleep time (p = .048 and p = .042, respectively).
Conclusions
The present results point out the importance of considering sleep complaints associated with painful TMD in adolescents.
This cross‐sectional study showed that painful temporomandibular disorder (TMD) was significantly associated with subjective sleep complaints as unrefreshed sleep and frequent awakenings in adolescents, aged 12 – 14 years old. The intensity of TMD pain was associated with poor sleep quality. Also, in adolescents with painful TMD, lower pressure pain thresholds in the trigeminal and extra‐trigeminal areas were associated with shorter total sleep time. Our findings pointed out the importance of considering sleep complaints in adolescents with painful TMD.