Evaluation of Association Between the Severity of Temporomandibular Disorders and Quality of Sleep in a Selected Iranian Population

Abstract

Objectives: Temporomandibular disorder (TMD), as a prevalent condition, has been reported to be related to changes in sleep quality. This study aims to assess the association between TMD severities and sleep quality in a selected Iranian population by the application of the Helkimo index and the Pittsburgh Sleep Quality Index (PSQI) questionnaire.

Materials and Methods: This study comprised 50 non-TMD subjects and 150 TMD patients, which were equally selected from each TMD severity category. The study was conducted at the School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. The patients were first examined and categorized into four TMD severity groups according to the Helkimo index: Non-TMD, mild, moderate, and severe. Then, the patients completed the PSQI questionnaire, which was a standard version translated into Persian and adjusted for Iranian patients.

Results: Comparison of mean PSQI scores of the four groups revealed a significant difference (P<0.001). Pairwise comparisons showed that the severe, moderate, and mild TMD groups and the control received the highest to the lowest PSQI scores (12.26±2.35, 8.20±1.92, 6.88±1.89, and 5.28±1.32, respectively). Similarly, regression analysis indicated that by controlling the effect of demographic variables, the mean PSQI significantly increased as TMD severity increased.

Conclusion: According to the results, all three categories of mild, moderate, and severe TMD patients showed poor quality of sleep in comparison with non-TMD controls. The higher the severity of the disease, the lower the sleep quality.