Insomnia with objective short sleep duration in women with temporomandibular joint disorder: quantitative sensory testing, inflammation and clinical pain profiles.
Insomnia with objective short sleep duration in women with temporomandibular joint disorder: quantitative sensory testing, inflammation and clinical pain profiles.
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DOI：
10.1016/j.sleep.2022.01.004
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发表时间：
2022-03
期刊：
影响因子：
4.8
通讯作者：
Smith MT
中科院分区：
文献类型：
--
作者：
Lerman SF;Mun CJ;Hunt CA;Kunatharaju S;Buenaver LF;Finan PH;Campbell CM;Phillips J;Fernandez-Mendoza J;Haythornthwaite JA;Smith MT
颞下颌关节紊乱病（TMD）是一种致残性面部疼痛综合征，主要影响女性，伴有高患病率的失眠。客观睡眠时间短的失眠（ISSD）是一种与心脏代谢发病率和死亡率增加有关的新兴表型。本报告探讨了临床和实验室疼痛和全身炎症在TMD的ISSD的关联。我们收集了128名患有TMD和失眠症的女性的基线数据，作为评估睡眠和疼痛心理干预的临床试验的一部分。参与者完成了自我报告问卷，一晚多导睡眠图，2周活动记录评估，定量感觉测试（QST），以评估冷痛耐受性，疼痛敏感性和中枢致敏性，并测量循环白细胞介素-6水平以评估全身炎症。24.2%（n=31）的样本符合ISSD标准[多导睡眠描记（睡眠持续时间<6小时）]。与失眠和睡眠时间正常的人相比，ISSD的年龄更大（40.4 vs. 34.9，p<0.05），自我认同为黑人的比例更大（48.4% vs. 11.3%，p<0.001）。多元回归分析显示，ISSD支持更高的自我报告疼痛的严重程度和功能限制的下巴。ISSD还表现出增加的全身疼痛敏感性，增强中枢敏感性，冷加压耐受性和较高的静息白细胞介素-6水平。这是第一个研究慢性疼痛样本中ISSD表型的特征，并将其负面健康结果的范围扩大到慢性疼痛。ISSD可能是一种重要的慢性疼痛表型，与更严重的临床和实验室疼痛特征相关，未来的研究应侧重于治疗反应和疾病轨迹的影响。
Temporomandibular joint disorder (TMD) is a disabling facial pain syndrome with a high prevalence of insomnia that primarily affects women. Insomnia with objective short sleep duration (ISSD) is an emerging phenotype linked to cardiometabolic morbidity and increased mortality. The present report examines the association of ISSD on clinical and laboratory pain and systemic inflammation in TMD. We collected baseline data from 128 women with TMD and insomnia as part of a clinical trial evaluating psychological interventions for sleep and pain. Participants completed self-report questionnaires, one-night polysomnography, a 2-week actigraphy assessment, quantitative sensory testing (QST) to assess cold pain tolerance, pain sensitivity and central sensitization and circulating Interleukin-6 levels were measured to assess systemic inflammation. 24.2% (n=31) of the sample met criteria for ISSD [polysomnography (sleep duration <6 hours)]. Compared to those with insomnia and normal sleep duration, ISSD were older (40.4 vs. 34.9, p<.05) and a greater proportion self-identified as Black (48.4% vs 11.3%, p<.001). Multivariate regressions revealed that ISSD endorsed higher self-report pain severity and functional limitation of the jaw. ISSD also demonstrated increased generalized pain sensitivity, enhanced central sensitization, cold pressor tolerance and higher resting interleukin-6 levels. This is the first study to characterize the ISSD phenotype in a chronic pain sample and expand the scope of its negative health outcomes to chronic pain. ISSD may be an important chronic pain phenotype associated with a more severe clinical and laboratory pain profile, and future studies should focus on implications for treatment response and disease trajectory.
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