Psychological Distress and Sleep Disturbance as Mediators in the Association Between Bodily Pain and Painful Temporomandibular Disorders.

OBJECTIVES

The aim of this study was to investigate the associations between bodily pain (BP) and painful temporomandibular disorders (PT) in the general population in China. It also focused on evaluating how psychological distress and sleep disturbance mediated the association.

MATERIALS AND

METHODS

Data were derived from a community survey conducted in mainland China in 2024 (N = 1920). Participants were categorised by BP sites: none (PF group), single site (SP group), and multiple sites (MP group). Psychological distress was measured using the Patient Health Questionnaire-4 (PHQ-4), and the Insomnia Severity Index (ISI) was used to evaluate sleep disturbances. Statistical analyses were performed using univariate and multivariate logistic regression analyses, as well as chain mediation analysis.

RESULTS

The prevalence of PT was highest in the MP group, followed by the SP group, and lowest in the PF group. Multivariate logistic regression showed that BP (SP: OR 1.672, 95% CI 1.27-2.202; MP: OR 2.148; 95% CI 1.661-2.776), PHQ-4 (OR 1.12; 95% CI 1.07-1.172), and ISI (OR 1.076; 95% CI 1.051-1.1) were positively associated with PT. Chain mediation analysis showed significant direct (Effect: 0.268; 95% CI 0.046-0.094) and the indirect effect of both PHQ-4 and ISI scores (Effect: 0.018; 95% CI 0.023-0.044) between BP and PT.

CONCLUSIONS

Psychological distress and sleep disturbance have a chain mediation effect on the association between BP and PT.

CLINICAL RELEVANCE: Our findings highlight the significance of considering the comorbidity of BP in patients with PT and implementing interventions that address psychological distress and sleep disturbance in clinical practice.