Sleep, Awake, or Combined Sleep/Awake Bruxism Against Temporomandibular Joint and/or Temporal Pain, Depression, Anxiety, Stress, and Sleep Quality: The Brigada Militar Study.

OBJECTIVES

To assess the association of sleep (SB), awake (AB), and combined SB/AB bruxism with temporomandibular joint and/or temporal pain, emotional dysregulation, depression, anxiety, stress, and sleep quality.

MATERIALS AND

METHODS

The sample (n=240) were police officers (Brigada Militar) in active duty (35% women, 69% less than 45 years old). The Temporomandibular Pain Screener short-version (Diagnostic Criteria for Temporomandibular Disorders - DC/TMD); the Difficulties in Emotion Regulation Scale (DERS); the Depression, Anxiety, and Stress Scale (DASS-21); and the Pittsburgh Sleep Quality Index (PSQI) were used for data collection.

RESULTS

The combined AB/SB showed more than twice the prevalence of AB and SB separately (45.6% versus 7.2% and 19.0%, respectively). Significantly moderate to strong positive associations (odds ratio - OR) were found in combined AB/SB for TMJ and/or temporal pain (14.33, p<0.001), depression (2.11, p<0.05), and stress (2.69, p<0.05); followed by AB for stress only (4.48, p<0.05); while SB had no significant associations. Regarding sleep variables, strong positive and significant associations (OR) were found: a) combined AB/SB for sleep quality (3.25, p<0.01) and sleep disturbance (5.14, p<0.01), and b) AB for sleep duration (3.60, p<0.05). No significant associations were found for SB against sleep variables. Combined AB/SB had more positive interactions with AB than with SB in most variables.

CONCLUSIONS

The new combined AB/SB bruxism classification has shown to have higher prevalences and stronger associations with most of the variables analyzed in this study as compared to AB or SB separately; therefore, future studies and consensus statements must include this new bruxism classification.