Sleep and depression as risk indicators for temporomandibular disorders in a cross-cultural perspective: a case-control study.
OBJECTIVE
We conducted this case-control study to determine the role of 2 neuropsychologic variables (sleep and depression) as possible risk indicators for the development of temporomandibular disorders (TMD).


METHODS
Neuropsychologic tests, traditional signs and symptoms of TMD, and social and economic variables were analyzed. Seventy-two predominantly muscle-related TMD patients (Research Diagnostic Criteria for TMD groups Ia, Ib, and IIIa) and 30 age- and sex-matched pain-free controls were included in the population.


RESULTS
Overall, TMD patients had statistically significantly higher sleep and depression scores on the Sleep Assessment Questionnaire and on the Brazilian Portuguese version of the Beck Depression Inventory, with odds ratios of 5 and 1.6, respectively. These results remained unchanged even after controlling for 8 confounders in the logistic regression analysis. Spontaneous pain and pain on palpation (grade 2 or higher) were also statistically significantly worse in TMD patients. In the forward-step logistic regression analysis, we also found that the combination of our best TMD predictors (ie, sleep, cigarettes, alcohol) had a better predictive value (percent agreement = 78.69%) than when the variables were analyzed alone.


CONCLUSIONS
Sleep and depression are considered important risk indicators for the development of TMD.
Selaimen
Caio M P
CM
Department of Prosthodontics, Catholic University of Rio Grande do Sul, Dental School, Brazil.
Jeronymo
José C M
JC
Brilhante
Diego P
DP
Grossi
Márcio L
ML
D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000453:epidemiology* / Q000209:etiology*