Temporal summation in women with TMJD compared with Healthy controls: Associations with Sleep quality and impaired physical activity

Abstract

Quality of sleep has been associated with physical functioning and disability in chronic pain patients. However the relations between endogenous pain modulation, sleep quality and disability in women with TMJD is not known. The goal of this study was to analyze the association of temporal summation of heat pain with disability and sleep quality in women with TMJD and healthy controls. A total of 55 women (30 TMJD, 25 controls) were enrolled in the study. All participants were screened over the phone. Eligible participants completed a clinical visit, which included psychological questionnaires, clinical examination and sensory tests (pressure, thermal and ischemic pain procedures), including temporal summation of heat pain. The statistical analyses included ANOVA and Regression. Our results indicated that TMJD women had greater sensitivity to temporal summation than controls at 46⁰C (p=0.012), 48⁰C (p=0.047) and borderline significance at 50⁰C (p=0.052). However, these group differences should be interpreted in light of a significant interaction between sleep quality and group, such that TMJD women who had poor quality of sleep had significantly elevated temporal summation at 46⁰C than control women (p=0.045). However, no group difference in temporal summation emerged for women with good sleep quality (p > 0.10). Regarding disability, temporal summation at 46⁰C was significantly and positively associated with reports of physical activity-related interference (p=0.031) in the TMJD group, after controlling for negative affect and clinical pain. TMJD women are more sensitive to temporal summation than controls, and this association appears to me moderated by sleep quality. Sleep dysfunction may increase temporal summation of pain in women with TMJD, which in turn may be associated with greater pain-related interference among women with TMJD. Quality of sleep has been associated with physical functioning and disability in chronic pain patients. However the relations between endogenous pain modulation, sleep quality and disability in women with TMJD is not known. The goal of this study was to analyze the association of temporal summation of heat pain with disability and sleep quality in women with TMJD and healthy controls. A total of 55 women (30 TMJD, 25 controls) were enrolled in the study. All participants were screened over the phone. Eligible participants completed a clinical visit, which included psychological questionnaires, clinical examination and sensory tests (pressure, thermal and ischemic pain procedures), including temporal summation of heat pain. The statistical analyses included ANOVA and Regression. Our results indicated that TMJD women had greater sensitivity to temporal summation than controls at 46⁰C (p=0.012), 48⁰C (p=0.047) and borderline significance at 50⁰C (p=0.052). However, these group differences should be interpreted in light of a significant interaction between sleep quality and group, such that TMJD women who had poor quality of sleep had significantly elevated temporal summation at 46⁰C than control women (p=0.045). However, no group difference in temporal summation emerged for women with good sleep quality (p > 0.10). Regarding disability, temporal summation at 46⁰C was significantly and positively associated with reports of physical activity-related interference (p=0.031) in the TMJD group, after controlling for negative affect and clinical pain. TMJD women are more sensitive to temporal summation than controls, and this association appears to me moderated by sleep quality. Sleep dysfunction may increase temporal summation of pain in women with TMJD, which in turn may be associated with greater pain-related interference among women with TMJD.