Subjective sleep quality and temporomandibular disorders: Systematic literature review and meta-analysis

Study objectives To assess the general subjective sleep quality in individuals with and without TMD, and its distribution among the TMD diagnostic groups. Methods A systematic review search was performed in Pubmed/MEDLINE, Embase, LILACS, Web of Science, SciELO, CINAHL and Cochrane Central as well as in the grey literature. Observational studies published since 1992 which used either the DC/TMD or RDC/TMD for TMD diagnosis and either the PSQI, SAQ or ESS questionnaires for sleep assessment were included. Articles selected for meta-analysis underwent quality, heterogeneity and publication bias evaluation. Results A total of 1071 articles were found by online search, and 10 articles were added manually. For full-text reading, 138 papers were selected. Thirty-six articles were included in the final review, and 19 in the meta-analysis (PSQI only). Subjective sleep quality was shown to be associated with all RDC/TMD or DC/TMD Axis I diagnostic groups: muscle disorders, arthralgia/osteoarthritis/osteoarthrosis and disk displacements; with the highest association in the first two groups, and the lowest in the last one. A 4.45 times increased odds ratio of TMD prevalence was found for individuals who presented poor subjective sleep quality. Conclusion Subjective sleep quality should be considered in the management of TMD.

Automated summary

This study evaluated the general subjective sleep quality in individuals with and without TMD, and found an association between subjective sleep quality and different TMD diagnostic groups, particularly muscle disorders and joint pain. Individuals with poor subjective sleep quality were found to have a significantly increased odds ratio of TMD prevalence.