Does Sleep Quality Affect Temporomandibular Joint With Degenerative Joint Changes?

Thuy Duong Tran Duy; Min-Chi Chen; Ellen Wen-Ching Ko; Yu-Ray Chen; Chiung Shing Huang

doi:10.1016/j.joms.2019.02.031

Does Sleep Quality Affect Temporomandibular Joint With Degenerative Joint Changes?

J Oral Maxillofac Surg. 2019 Aug;77(8):1594-1601. doi: 10.1016/j.joms.2019.02.031. Epub 2019 Feb 25.

Authors

Thuy Duong Tran Duy¹, Min-Chi Chen², Ellen Wen-Ching Ko³, Yu-Ray Chen⁴, Chiung Shing Huang⁵

Affiliations

¹ Research Fellow, Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
² Professor, Department of Public Health, Biostatistics Consulting Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan; and Professor, Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
³ Professor, Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Professor, Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; and Professor, Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.
⁴ Professor, Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Professor, Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; and Professor, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
⁵ Professor, Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Professor, Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; and Professor, Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan. Electronic address: sshuang@ms1.hinet.net.

PMID: 30904551
DOI: 10.1016/j.joms.2019.02.031

Abstract

Purpose: 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 the temporomandibular joints (DJC-TMJ)?

Materials and methods: We designed a prospective cohort study and enrolled female patients who required orthognathic surgery 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 orthognathic surgery. The predictor variable was sleep quality, documented either as poor, indicated by a Pittsburgh Sleep Quality Index (PSQI) score of 5 or greater, or as good, indicated by a PSQI score of less than 5. The primary outcome variable was the presence of 5 or more DJC-TMJ signs or fewer than 5 DJC-TMJ signs. Other associated variables were grouped into the following categories: demographic variables (age and body mass index) 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: good sleep quality group (n = 25, PSQI score < 5) and poor sleep quality group (n = 27, PSQI score ≥ 5). Poor sleep quality was significantly associated (P = .027) with an increase in DJC-TMJ signs. In the multiple regression model, a PSQI score of 5 or greater (adjusted odds ratio, 5.806; 95% confidence interval, 1.406 to 23.974) and greater sella-nasion-point A angle (adjusted odds ratio, 1.453; 95% confidence interval, 1.127 to 1.871) were significantly associated (P < .05) with an increased prevalence of DJC-TMJ.

Conclusions: 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.

MeSH terms

Female
Humans
Orthognathic Surgical Procedures*
Prospective Studies
Sleep Wake Disorders* / etiology
Sleep*
Temporomandibular Joint
Temporomandibular Joint Disorders* / complications
Temporomandibular Joint Disorders* / surgery