Headache Impairs Sleep, Catastrophizing and Muscle Pain in TMD Subjects

Objectives: To measure the impact of primary phenotype headache associated with masticatory myofascial pain (MMP) on sleep quality, catastrophic pain thoughts, pressure pain threshold (PPT) and intensity of facial pain.
Methods: A total of 97 MMP subjects diagnosed according to the revised RDC/TMD criteria with (group I, n = 50) or without (group II, n = 47) associated headache complaints were recruited. The outcome measures were: a) the Pittsburgh Sleep Quality Index (PSQI); b) The Catastrophizing Thoughts sub-scale of the Pain Related Self-Statement Scale (PRSS-C); c) pressure pain threshold (PPT) of the masseter and anterior temporalis (AT); d) the reported facial pain intensity measured with the aid of a 0-10 cm Visual Analogue Scale (VAS). Kolmogorov-Smirnov and the Student's T-test (α = 5%) were applied to the data.
Results: Mean age (SD) and sex distribution were 29.4 years (6.2) group I (88% females) and 27.4 years (7.0) for group II (80% females). Group I had worse sleep quality scores, (9.1 (3.5)) compared with group II (7.2 (3.4); p = 0.008). Also, the pain catastrophizing was higher in group I (2.2 (1.2)) than in group II (1.63 (1.4); p = 0.04). The PPT (kgf/cm²) values at the masseter and AT were lower in group I (1.5 (0.5); 1.2 (0.43)) than in group II (2.09 (0.73); 1.7 (0.68); p < 0.001). Finally, there was no difference in facial pain intensity (6.2 (1.8) vs.5.4 (2.2); p = 0.08).
Conclusions: The presence of headache is negatively associated with sleep quality, pain catastrophizing, and deep pain sensitivity in MMP subjects.