Racial Disparities in Sleep and Pain Among Individuals with Temporomandibular Joint Disorder Assessed with Sleep Diary, Polysomnography, and Actigraphy

Abstract

Temporomandibular joint disorder (TMD) is an idiopathic chronic pain condition and often associated with sleep disturbance. Although racial pain and sleep disparities have been observed in other pain populations, less is known about such disparities in TMD. Given that pain is strongly associated with sleep, Black individuals may experience compounded disparities involving worse pain and sleep outcomes compared to White individuals. Participants (105= White, 26 = Black) completed baseline questionnaires, including the Brief Pain Inventory (BPI), Fear of Pain Questionnaire (FOP), Pain Catastrophizing Scale (PCS), Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS), Insomnia Severity Index (ISI), and Dysfunctional Beliefs About Sleep Scale (DBAS). After completing baseline questionnaires, patients completed one night of polysomnography (PSG). Participants completed a 14-day diary assessing sleep continuity which was also objectively measured via actigraphy. Sleep continuity data were aggregated as individual 14-day means. Analyses controlled for age, household income, and education. Black participants reported higher pain severity (p