title: Review of self-reported instruments that measure sleep dysfunction in patients suffering from temporomandibular disorders and/or orofacial pain.
abstract: Patients with temporomandibular disorders (TMD) and/or orofacial pain (OFP) frequently experience poor sleep quality or suffer from comorbid sleep disorders. Study results suggest that in chronic pain patients, an improvement in sleep quality critically influences the outcomes of interventions on mood and pain. Yet, only a few studies have systematically sought to evaluate the sleep quality of TMD/OFP patients. Standardized and validated self-reported instruments designed for screening sleep disturbances or for the evaluation of treatment outcomes in this population would therefore enhance evidence and improve treatment options. The objectives of the present study were: (1) to review the self-reported instruments that measure sleep dysfunction in studies on TMD/OFP patients, by conducting a systematic literature search; (2) to evaluate their clinimetric evidence; and (3) to provide guidance for future research using such instruments. A total of 26 papers, using eight different instruments, were identified. The most frequently used questionnaires and the only ones with good clinimetric properties were the Insomnia Severity Index followed by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. They were most reliable, valid and time-effective for measuring sleep dysfunctions in patients with TMD/OFP, with only a few practical constraints. Yet, in future studies, an assessment of the relationship between sleep disturbances and chronic pain will have to include instruments measuring the effect of mediator variables such as cognitive or emotional arousal. Research is required to clarify if existing self-reported questionnaires measuring these aspects will promote further insights or if there is a need for new instruments. This future research direction would blend into the overall biopsychosocial concept of TMD/OFP diagnoses and treatment.
authors.affiliation: Center for Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, University of Zurich, Zurich, Switzerland.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Sommer
authors.affiliation: Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada; Faculté de Médecine Dentaire, Université de Montréal, Canada.
authors.forename: Gilles
authors.initials: G
authors.lastname: Lavigne
authors.affiliation: Center for Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, University of Zurich, Zurich, Switzerland. Electronic address: dominik.ettlin@zzm.uzh.ch.
authors.forename: Dominik A
authors.initials: DA
authors.lastname: Ettlin
mesh_terms: D059350:Chronic Pain / Q000150:complications* / Q000523:psychology; D005157:Facial Pain / Q000150:complications* / Q000523:psychology; D006801:Humans; D010147:Pain Measurement; D015203:Reproducibility of Results; D057566:Self Report; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000150:complications* / Q000523:psychology
keywords: Facial pain; Questionnaires; Review; Sleep; Sleep Initiation and Maintenance Disorders; Temporomandibular disorders