Polysomnographic Investigation of Sleep and Respiratory Parameters in Women with Temporomandibular Pain Disorders
Polysomnographic Investigation of Sleep and Respiratory Parameters in Women with Temporomandibular Pain Disorders
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DOI：
10.5664/jcsm.3452
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发表时间：
2014-01-01
影响因子：
4.3
通讯作者：
Krieger, Ana C.
中科院分区：
文献类型：
--
作者：
Dubrovsky, Boris;Raphael, Karen G.;Krieger, Ana C.
研究目的：临床上，颞下颌关节疼痛障碍（TMD）和肌筋膜疼痛与失眠和阻塞性睡眠呼吸暂停（OSA）患病率增加有关。然而，文献缺乏一个准确的多导睡眠图（PSG）与TMD相关的睡眠异常的特点，鉴于以前的研究包括小或不受控制的样本TMD患者。本调查的目的是客观地评估一个大的代表性样本的TMD病例中的睡眠和呼吸障碍的措施，比较与matchedcontrols.Methods：睡眠，呼吸，和肢体运动进行了测量，使用2晚出席PSG协议在170名妇女-124 TMD的情况下，肌筋膜疼痛和46人口统计学匹配的控制。使用ANCOVA比较组间第二晚数据。在TMD的情况下，疼痛等级和睡眠参数之间的关系进行了分析，使用multiple regressions.Results：在比较健康对照组，TMD的情况下，证明了一个显着增加阶段N1睡眠（12.2% +/-7.6%vs.9.2%+/-5.0%，p = 0.03），这只是轻微的相对于正常值。TMD病例还表现出与所有类型呼吸事件相关的觉醒（6.0/h +/- 6.1 vs. 3.5/h +/- 3.3 p = 0.02）和呼吸努力相关觉醒（RERA，4.3/h +/- 4.3 vs. 2.6/h +/- 2.7，p = 0.02）轻度但显著升高。肌筋膜疼痛预测较低的睡眠效率（p = 0.01），更频繁的觉醒（p = 0.04），和较高的RERA指数（p = 0.04）在TMD cases.Conclusions：肌筋膜疼痛在TMD是与轻度升高的睡眠片段和增加频率的RERA事件。需要进一步的研究来评估这些发现的临床意义。
Study Objectives: Temporomandibular pain disorders (TMD) and myofascial pain were linked to increased prevalence of insomnia and obstructive sleep apnea (OSA) on clinical grounds. However, the literature lacks an accurate polysomnographic (PSG) characterization of sleep abnormalities associated with TMD, given that prior studies included small or uncontrolled samples of TMD patients. The present investigation aims to objectively evaluate measures of sleep and respiratory disturbance in a large representative sample of TMD cases in comparison with matched controls.Methods: Sleep, respiration, and limb movements were measured using a 2-night attended PSG protocol in 170 women-124 TMD cases with myofascial pain and 46 demographically matched controls. The second night data were compared between the groups using ANCOVAs. In TMD cases, the relationship between pain ratings and sleep parameters was analyzed using multiple regressions.Results: In comparison to healthy controls, TMD cased evidenced a significant increase in stage N1 sleep (12.2% +/- 7.6% vs. 9.2% +/- 5.0%, p = 0.03), which was only mild relative to normative values. TMD cases also demonstrated mild but signifi cant elevations in arousals associated with all types of respiratory events (6.0/h +/- 6.1 vs. 3.5/h +/- 3.3 p = 0.02) and in respiratory effort related arousals (RERAs, 4.3/h +/- 4.3 vs. 2.6/h +/- 2.7, p = 0.02). Myofascial pain predicted a lower sleep effi ciency (p = 0.01), more frequent awakenings (p = 0.04), and higher RERA index (p = 0.04) among TMD cases.Conclusions: Myofascial pain in TMD is associated with mild elevation in sleep fragmentation and increased frequency of RERA events. Further research is required to evaluate the clinical significance of these findings.