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The Relationship between Sleep Quality and Clinical Features of Adolescents with Temporomandibular Disorder
J Oral Med Pain 2018;43:27-33
Published online June 30, 2018;
© 2018 Korean Academy of Orofacial Pain and Oral Medicine

Yang Mi Park1, Sunhee Lee1, Kyung-Hee Kim2, Yong-Woo Ahn1,3, Sung-Hee Jeong1,3, Soo-Min Ok1,3

1Department of Oral Medicine, School of Dentistry, Pusan National University, Yangsan, Korea
2Department of Oral Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
3Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
Correspondence to: Soo-Min Ok
Department of Oral Medicine, Pusan National University Dental Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea
Tel: +82-55-360-5242
Fax: +82-55-360-5238
Received March 9, 2018; Revised April 4, 2018; Accepted April 6, 2018.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Many researchers have established a connection between sleep disturbances and the symptoms of temporomandibular disorder (TMD) in adults, but there are a few studies targeted at adolescents with TMD. The aim of this study was to analyze the sleep pattern of adolescents with TMD and to determine the effect of poor sleep quality on their clinical symptoms.
Methods: The subjects were composed of 47 adolescents with TMD. The sleep pattern and preliminary information of patients were measured by self-reported questionnaires; Pittsburgh Sleep Quality Index (PSQI) and Questionnaire for TMD analysis. TMD pain was scored using the Numerical Rating Scale. The Kruskal-Wallis test, Mann-Whitney U test, Fisher’s exact test and logistic regression were used for statistical analysis.
Results: The poor sleeping group had statistically more females (25.00% males, 75.00% females) than the good sleeping group. As compared with that of good sleepers, sleep quality of poor sleepers was significantly worse in the items of subjective sleep quality, sleep latency, sleep duration, sleep disturbances, daytime dysfunction and global PSQI score. The sleep time of adolescents was much longer during vacation (7.20±1.38 hours) than during school days (6.10±1.26 hours). Poor sleep of patients was associated with the pain in the ear or in front of the ear, in the face, jaw, throat or temple and in neck or back. Adolescents with pain in those areas had significantly higher proportion of poor sleepers than adolescents with no pain in those areas.
Conclusions: The high ratio of girls in poor sleeping group could reflect the greater prevalence of TMD in women than in men. Pain in peri-temporomandibular joint areas, neck or back could negatively influence sleep quality of adolescents with TMD.
Keywords : Adolescent; Pain; Questionnaires; Sleep; Temporomandibular joint disorders

March 2019, 44 (1)