Associations Between Temporomandibular Disorder-Related Symptoms, Psychological Distress, and Sleep Quality Among Hospital Healthcare Staff.

OBJECTIVES

To examine associations between temporomandibular disorder (TMD)-related symptoms, psychological distress, and sleep quality among hospital healthcare staff, and to explore whether cumulative psychological-sleep burden was associated with pain-related TMD in a graded pattern.

MATERIALS AND

METHODS

This cross-sectional study included 193 healthcare employees from a tertiary public hospital in Beijing, China. TMD-related symptoms were assessed using self-reported symptom items from the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Symptom Questionnaire for symptom screening rather than definitive clinical diagnosis. Psychological distress was measured using the Depression Anxiety Stress Scales-21 (DASS-21), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). An exploratory psychological-sleep composite burden index was constructed by summing standardized depression, anxiety, stress, and global PSQI scores. Multivariable logistic regression models evaluated associations between the composite index and pain-related TMD, adjusting for age group, sex, and occupational role. Quartile-based trend and sensitivity analyses were performed.

RESULTS

Pain-related TMD was reported by 67 participants (34.7%). Each 1-SD increase in the composite index showed a positive but borderline association with pain-related TMD (adjusted OR = 1.36, 95% CI: 1.00-1.86, p = 0.052). In quartile-based analysis, each higher burden quartile was associated with increased odds of pain-related TMD (adjusted OR = 1.37, 95% CI: 1.03-1.81, p = 0.030). After excluding headache-only cases, the quartile-based association remained significant (adjusted OR = 1.37, 95% CI: 1.02-1.85, p = 0.037). Symptom-specific analyses showed heterogeneous patterns.

CONCLUSIONS

Higher cumulative psychological-sleep burden was associated with greater odds of pain-related TMD among hospital healthcare staff, particularly in quartile-based analyses. These findings support a cautious biopsychosocial interpretation and suggest that psychological distress and sleep quality may be relevant considerations in occupational oral health assessment.