DOI QR코드

DOI QR Code

Evaluation of Sleep Quality and Psychological Profiles in Patients with Chronic Painful Temporomadibular Disorders

  • Jeon, Hye-Mi (Dental Clinic Center, Pusan National University Hospital) ;
  • Han, Kyung-Hun (Division of Sport Science, Pusan National University) ;
  • Ju, Hye-Min (Department of Oral Medicine, Pusan National University School of Dentistry) ;
  • Ahn, Yong-Woo (Department of Oral Medicine, Pusan National University School of Dentistry) ;
  • Ok, Soo-Min (Department of Oral Medicine, Pusan National University School of Dentistry) ;
  • Jeong, Sung-Hee (Department of Oral Medicine, Pusan National University School of Dentistry)
  • Received : 2020.06.03
  • Accepted : 2020.06.14
  • Published : 2020.06.30

Abstract

Purpose: Temporomadibular disorders (TMDs) can result in chronic pain, which is often associated with psychological and sleep disturbance. Increased levels of psychological and sleep impairments are often related with poor treatment outcomes. The purpose of the present study was to evaluate clinical features, psychological profiles and the prevalence of clinical insomnia in TMD patients with chronic pain and to suggest an effective treatment approach. Methods: A total of 200 TMD patients who had visited the Pusan National University Hospital dental clinic for treatment of their pain were recruited from June 2018 through December 2019. TMD patients were classified into an acute (n=100) and chronic (n=100) group and compared the clinical symptoms. The primary diagnosis of TMD were categorized as TMD with joint pain group (TMD_J), TMD with muscle pain group (TMD_M) and TMD with joint-muscle mixed pain group (TMD_JM). Self- report measures of sleep quality and psychological profiles were evaluated via the Insomnia Severity Index (ISI) and the Korean Stress Response Inventory (SRI). Independent t-tests, Mann-Whitney U-tests, and chisquared test were used for the statistical analysis. Results: Chronic TMD patients showed higher pain intensity, as well as higher prevalence of related symptoms (headache, musculoskeletal pain) and myogenous pain. They also had significantly higher scores in all SRI parameters and a higher percentage of clinical insomnia than acute TMD patients. Conclusions: Based on the above results, psychological profiles and sleep quality assessments are necessary to provide essential data that will allow for improved treatment of chronic TMD patients.

Keywords

References

  1. Kim HJ, Jang JH, Chung JW. Comparison of clinical symptoms and psychological profiles of temporomandibular joint osteoarthritis between juveniles and adults. J Oral Med Pain 2016;41:48-53. https://doi.org/10.14476/jomp.2016.41.2.48
  2. Park JH, Shim YJ, Lim HD, Lee YM, Kang JK. Evaluation of anxiety and depression in patients with disc displacement according to diagnostic criteria for temporomandibular disorders. J Oral Med Pain 2018;43:125-130. https://doi.org/10.14476/jomp.2018.43.4.125
  3. Laskin DM, Greene CS, Hylander WL. Temporomandibular disorders: an evidence-based approach to diagnosis and treatment. Chicago: Quintessence; 2006. pp. 203-207.
  4. Koh KB, Park JK, Kim CH, Cho S. Development of the stress response inventory and its application in clinical practice. Psychosom Med 2001;63:668-678. https://doi.org/10.1097/00006842-200107000-00020
  5. Kim SH, Lee DH, Yoon KB, An JR, Yoon DM. Factors associated with increased risk for clinical insomnia in patients with chronic neck pain. Pain Physician 2015;18:593-598.
  6. Song KW, Kim ME. Sleep quality of patients with temporomandibular disorders: relationship to clinical and psychological characteristics. J Oral Med Pain 2015;40:155-162. https://doi.org/10.14476/jomp.2015.40.4.155
  7. Nicassio PM, Moxham EG, Schuman CE, Gevirtz RN. The contribution of pain, reported sleep quality, and depressive symptoms to fatigue in fibromyalgia. Pain 2002;100:271-279. https://doi.org/10.1016/S0304-3959(02)00300-7
  8. Menefee LA, Cohen MJ, Anderson WR, Doghramji K, Frank ED, Lee H. Sleep disturbance and nonmalignant chronic pain: a comprehensive review of the literature. Pain Med 2000;1:156-172. https://doi.org/10.1046/j.1526-4637.2000.00022.x
  9. Emery PC, Wilson KG, Kowal J. Major depressive disorder and sleep disturbance in patients with chronic pain. Pain Res Manag 2014;19:35-41. https://doi.org/10.1155/2014/480859
  10. Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2001;2:297-307. https://doi.org/10.1016/S1389-9457(00)00065-4
  11. Cho YW, Song ML, Morin CM. Validation of a Korean version of the insomnia severity index. J Clin Neurol 2014;10:210-215. https://doi.org/10.3988/jcn.2014.10.3.210
  12. Laskin DM, Greene CS, Hylander WL. Temporomandibular disorders: an evidence-based approach to diagnosis and treatment. Chicago: Quintessence; 2006. pp. 255-269.
  13. Smith GR. The epidemiology and treatment of depression when it coexists with somatoform disorders, somatization, or pain. Gen Hosp Psychiatry 1992;14:265-272. https://doi.org/10.1016/0163-8343(92)90097-T
  14. Fishbain DA, Cutler R, Rosomoff HL, Rosomoff RS. Chronic painassociated depression: antecedent or consequence of chronic pain? A review. Clin J Pain 1997;13:116-137. https://doi.org/10.1097/00002508-199706000-00006
  15. Kaplan GA, Roberts RE, Camacho TC, Coyne JC. Psychosocial predictors of depression. Prospective evidence from the human population laboratory studies. Am J Epidemiol 1987;125:206-220. https://doi.org/10.1093/oxfordjournals.aje.a114521
  16. Slack D, Vaux A. Undesirable life events and depression: the role of event appraisals and social support. J Soc Clin Psychol 1988;7:290-296. https://doi.org/10.1521/jscp.1988.7.4.290
  17. Hurtig IM, Raak RI, Kendall SA, Gerdle B, Wahren LK. Quantitative sensory testing in fibromyalgia patients and in healthy subjects: identification of subgroups. Clin J Pain 2001;17:316-322. https://doi.org/10.1097/00002508-200112000-00005
  18. Park JW, Clark GT, Kim YK, Chung JW. Analysis of thermal pain sensitivity and psychological profiles in different subgroups of TMD patients. Int J Oral Maxillofac Surg 2010;39:968-974. https://doi.org/10.1016/j.ijom.2010.06.003
  19. Lindroth JE, Schmidt JE, Carlson CR. A comparison between masticatory muscle pain patients and intracapsular pain patients on behavioral and psychosocial domains. J Orofac Pain 2002;16:277-283.
  20. Troeltzsch M, Cronin RJ, Brodine AH, Frankenberger R, Messlinger K. Prevalence and association of headaches, temporomandibular joint disorders, and occlusal interferences. J Prosthet Dent 2011;105:410-417. https://doi.org/10.1016/S0022-3913(11)60084-X
  21. Wiklund T, Linton SJ, Alfoldi P, Gerdle B. Is sleep disturbance in patients with chronic pain affected by physical exercise or ACTbased stress management?: a randomized controlled study. BMC Musculoskelet Disord 2018;19:111. https://doi.org/10.1186/s12891-018-2020-z
  22. Dragioti E, Levin LA, Bernfort L, Larsson B, Gerdle B. Insomnia severity and its relationship with demographics, pain features, anxiety, and depression in older adults with and without pain: cross-sectional population-based results from the PainS65+ cohort. Ann Gen Psychiatry 2017;16:15. https://doi.org/10.1186/s12991-017-0137-3

Cited by

  1. Nursing Intervention Based on Smart Medical Care on the Sleep Quality of Cardiology Patients vol.2021, 2020, https://doi.org/10.1155/2021/9947438