Sleep misperception in women with myofascial temporomandibular disorder.

STUDY

OBJECTIVES

Temporomandibular disorders (TMDs) were linked to poor sleep on the Pittsburgh Sleep Quality Index (PSQI), whereas polysomnography revealed no major sleep disturbances, implying sleep state misperception. This study investigates sleep state misperception in TMD and control participants; correlates sleep state misperception with objective short sleep duration (SSD), depression symptoms, daytime sleepiness, and orofacial pain; and compares objective SSD between the groups.

METHODS

General linear models were used to compare second-night polysomnography total sleep time, sleep latency, sleep efficiency (SE), and wake after sleep onset with homologous PSQI-derived variables in 124 women with myofascial TMD and 46 age and body mass index matched controls. PSQI variables were regressed onto objective SSD, depression symptoms, daytime sleepiness, and pain. Lastly, objective SSD was related to TMD presence.

RESULTS

Compared to controls, TMD cases misperceived SE (P = .02); depression symptoms explained PSQI-derived SE (P = .002) and mediated the effect of pain (P < .001). PSQI variables were unrelated to respective polysomnography measures or objective SSD, except a significant self-reported-objective correlation in SE among controls only (P = .002). Objective SSD was more frequent in TMD cases (P = .02, odds ratio = 2.95), but it was unrelated to depression symptoms, daytime sleepiness, or prepolysomnography pain.

CONCLUSIONS

The study demonstrates misperception of SE among TMD cases, which was accounted for by depression symptoms. Objective SSD nearly tripled in TMD cases; however, it was unrelated to PSQI variables, depression, daytime sleepiness, or pain, suggesting that sleep state misperception and objective SSD are 2 independent sleep features in TMD.

CITATION: Chan C, Dubrovsky B, Bouchard M, Tartter VC, Raphael KG. Sleep misperception in women with myofascial temporomandibular disorder. J Clin Sleep Med. 2025;21(1):55-64.