Depressive symptoms account for differences between self-reported versus polysomnographic assessment of sleep quality in women with myofascial TMD.
Depressive symptoms account for differences between self-reported versus polysomnographic assessment of sleep quality in women with myofascial TMD.
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DOI：
10.1111/joor.12552
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发表时间：
2017-12
影响因子：
2.9
通讯作者：
Raphael KG
中科院分区：
文献类型：
--
作者：
Dubrovsky B;Janal MN;Lavigne GJ;Sirois DA;Wigren PE;Nemelivsky L;Krieger AC;Raphael KG
颞下颌关节紊乱病（TMD）患者报告匹兹堡睡眠质量指数（PSQI）睡眠质量差。然而，多导睡眠图（PSG）研究显示，睡眠障碍的标准生理措施的证据不足。本研究旨在分析TMD患者自我报告的睡眠质量与肌筋膜疼痛、PSG参数和抑郁症的关系。PSQI评分从124名妇女与肌筋膜TMD和46个匹配的对照进行了分层回归到TMD的存在，疼痛强度和疼痛相关的残疾，在实验室PSG变量，和抑郁症状（症状检查表-90）的评级。与对照组相比，TMD患者PSQI评分较高，表明主观睡眠较差，抑郁症状较多（均P < 0.001）。PSQI评分越高，抑郁症状越多（P < 0.001，R2 = 26%）。在19个PSG变量中，有两个对较高的PSQI评分有适度的贡献：TMD病例中REM潜伏期较长（P = 0.01，R2 = 3%），所有参与者中觉醒次数较多（P = 0.03，R2 = 2%）。在考虑了这些因素后，TMD的存在和疼痛评分与PSQI评分没有显著相关。这些结果表明，抑郁症状比PSG评估的睡眠障碍或肌筋膜疼痛更能解释TMD睡眠质量差。由于TMD病例缺乏临床抑郁症的典型PSG特征，结果表明TMD存在负面认知偏差，并警告不要将自我报告的睡眠测量结果解释为PSG睡眠障碍的准确指标。未来的研究在解释睡眠不佳的报告时，应考虑抑郁症。
Temporomandibular disorder (TMD) patients report poor sleep quality on the Pittsburgh Sleep Quality Index (PSQI). However, polysomnographic (PSG) studies show meager evidence of sleep disturbance on standard physiological measures. The present aim was to analyze self-reported sleep quality in TMD as a function of myofascial pain, PSG parameters, and depressive symptomatology. PSQI scores from 124 women with myofascial TMD and 46 matched controls were hierarchically regressed onto TMD presence, ratings of pain intensity and pain-related disability, in-lab PSG variables, and depressive symptoms (Symptoms Checklist-90). Relative to controls, TMD cases had higher PSQI scores, representing poorer subjective sleep, and more depressive symptoms (both P < 0.001). Higher PSQI scores were strongly predicted by more depressive symptoms (P < 0.001, R2 = 26%). Of 19 PSG variables, two had modest contributions to higher PSQI scores: longer REM latency in TMD cases (P = 0.01, R2 = 3%) and more awakenings in all participants (P = 0.03, R2 = 2%). After accounting for these factors, TMD presence and pain ratings were not significantly related to PSQI scores. These results show that reported poor sleep quality in TMD is better explained by depressive symptoms than by PSG-assessed sleep disturbances or myofascial pain. As TMD cases lacked typical PSG features of clinical depression, the results suggest a negative cognitive bias in TMD and caution against interpreting self-report sleep measures as accurate indicators of PSG sleep disturbance. Future investigations should take account of depressive symptomatology when interpreting reports of poor sleep.
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影响因子：
3
作者：
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通讯作者：
de Siqueira, Jose Tadeu Tesseroli
影响因子：
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影响因子：
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