Does sleep quality affect temporomandibular joint with degenerative joint changes?

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Tran Duy Thuy Duong, Min-Chi Chen, Ellen Wen-Ching Ko, Yu-Ray Chen, Chiung Shing Huang

Abstract

Objectives

The purpose of this study was to answer the following question: among female patients who have skeletal Class III malocclusion, does poor sleep quality increase the prevalence of degenerative joint changes in temporomandibular joints (DJC-TMJ)?

Materials and Methods

The authors designed a prospective cohort study and enrolled female patients who required orthognathic surgery (OGS) to correct skeletal Class III malocclusion from January 2014 to December 2017. This is the first serial study to identify the relationship between sleep quality and DJC-TMJ before OGS. The predictor variable was sleep quality documented as poor sleep, indicated by a Pittsburgh Sleep Quality Index (PSQI) score of ≥5, or good sleep, indicated by a PSQI score of <5. The primary outcome variable was the presence of ≥5 or <5 DJC-TMJ signs. Other associated variables were grouped into the following categories: demographic variables (age and body mass index [BMI]) and cephalometric data. Descriptive bivariate statistics were computed and univariate and multiple logistic regression analyses were conducted to identify factors associated with DJC-TMJ.

Results

The sample was composed of 52 patients grouped as follows: a good sleep group (n = 25, PSQI < 5) and poor sleep group (n = 27, PSQI ≥ 5). Poor sleep quality was significantly associated (P = 0.027) with an increase in DJC-TMJ signs. In the multiple regression model, a PSQI score of ≥5 (adjusted odds ratio: 5.806; 95% confidence interval: 1.406–23.974) and greater SNA (adjusted odds ratio: 1.453; 95% confidence interval: 1.127–1.871) were significantly associated (P < 0.05) with an increased prevalence of DJC-TMJ.

Conclusion

The results of this study suggest that in female patients with skeletal Class III malocclusion, poor sleep quality could increase the prevalence of DJC-TMJ. Future cohort studies are required to support that sleep disturbance can increase DJC-TMJ in the general population.

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