title: Sleep apnea symptoms and risk of temporomandibular disorder: OPPERA cohort.
abstract: The authors tested the hypothesis that obstructive sleep apnea (OSA) signs/symptoms are associated with the occurrence of temporomandibular disorder (TMD), using the OPPERA prospective cohort study of adults aged 18 to 44 years at enrollment (n = 2,604) and the OPPERA case-control study of chronic TMD (n = 1,716). In both the OPPERA cohort and case-control studies, TMD was examiner determined according to established research diagnostic criteria. People were considered to have high likelihood of OSA if they reported a history of sleep apnea or ≥ 2 hallmarks of OSA: loud snoring, daytime sleepiness, witnessed apnea, and hypertension. Cox proportional hazards regression estimated hazard ratios (HRs) and 95% confidence limits (CL) for first-onset TMD. Logistic regression estimated odds ratios (OR) and 95% CL for chronic TMD. In the cohort, 248 individuals developed first-onset TMD during the median 2.8-year follow-up. High likelihood of OSA was associated with greater incidence of first-onset TMD (adjusted HR = 1.73; 95% CL, 1.14, 2.62). In the case-control study, high likelihood of OSA was associated with higher odds of chronic TMD (adjusted OR = 3.63; 95% CL, 2.03, 6.52). Both studies supported a significant association of OSA symptoms and TMD, with prospective cohort evidence finding that OSA symptoms preceded first-onset TMD.
authors.affiliation: University of North Carolina at Chapel Hill, Koury Oral Health Sciences Building, 385 South Columbia Street, Chapel Hill, NC 27599-7450, USA. anne_sanders@dentistry.unc.edu
authors.forename: A E
authors.initials: AE
authors.lastname: Sanders
authors.forename: G K
authors.initials: GK
authors.lastname: Essick
authors.forename: R
authors.initials: R
authors.lastname: Fillingim
authors.forename: C
authors.initials: C
authors.lastname: Knott
authors.forename: R
authors.initials: R
authors.lastname: Ohrbach
authors.forename: J D
authors.initials: JD
authors.lastname: Greenspan
authors.forename: L
authors.initials: L
authors.lastname: Diatchenko
authors.forename: W
authors.initials: W
authors.lastname: Maixner
authors.forename: R
authors.initials: R
authors.lastname: Dubner
authors.forename: E
authors.initials: E
authors.lastname: Bair
authors.forename: V E
authors.initials: VE
authors.lastname: Miller
authors.forename: G D
authors.initials: GD
authors.lastname: Slade
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D009765:Obesity / Q000150:complications; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D012894:Sleep Stages / Q000502:physiology; D012907:Smoking; D012913:Snoring / Q000150:complications; D013705:Temporomandibular Joint Disorders / Q000150:complications*; D044465:White People; D055815:Young Adult
keywords: autonomic effect; case-control studies; chronic pain; cohort studies; epidemiology; sleep-disordered breathing