Associations Between Temporomandibular Disorder Subtypes, Emotional Distress, Impaired Sleep and Oral-Health Related Quality of Life in Asian Patients

Objectives: This study determined the differences in emotional states, sleep, and oral health-related quality of life (OHRQoL) between patients with pain-related and intra-articular Temporomandibular disorders (TMDs), and correlated emotional symptoms with sleep and OHRQoL variables.
Methods: Subjects were recruited from a tertiary TMDs referral center. The Depression, Anxiety, Stress Scales-21 (DASS-21), Pittsburgh Sleep Quality Index (PSQI), and Oral Health Impact Profile-TMDs (OHIP-TMDs) were used to assess emotional states, sleep disturbance, and OHRQoL respectively. TMD-related and sociodemographic data were also gathered. Patients were divided into pain-related (PT), intra-articular (IT) and combined TMDs (CT) groups based on the Diagnostic Criteria for TMDs. Data were analyzed using parametric and logistic regression analysis with the significance level set at P<0.05.
Results: Data of 1079 patients with a mean age of 29.63±14.22 years were appraised. The severity/prevalence of emotional distress, impaired sleep, and OHRQoL of the PT/CT groups were significantly higher than the IT group. Moderate to strong inter-relationships between emotional, sleep, and OHRQoL variables were more explicit for patients with painful TMDs. Logistic regression analysis demonstrated that painful-TMDs were associated with higher stress and lower OHRQoL with odds ratios (ORs) of 1.482 and 6.502, respectively (P<0.05).
Conclusions: Patients with pain-related TMDs reported high levels of emotional distress, disturbed sleep, and impaired OHRQoL. Stress and impaired OHRQoL were significantly related to painful TMDs.